Antepartum haemorrhage

1. Big picture

Antepartum haemorrhage (APH) means bleeding from the genital tract in late pregnancy before delivery. It is one of the most important obstetric emergencies because it can rapidly threaten both the mother and the fetus.

The examiner wants this logic:

Pregnant woman with vaginal bleeding after viability
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Mother first: ABC, vitals, IV access, bloods, resuscitation
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Assess fetus if viable: fetal heart/CTG
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Do NOT perform digital vaginal examination until placenta previa is excluded
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Find the cause: previa / abruption / vasa previa / uterine rupture / local lesion
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Treat according to maternal stability, fetal condit