Antepartum Hemorrhage Overview

Vaginal bleeding occurring after 20 weeks of pregnancy but before delivery.

The main cause of maternal and fetal morbidity and mortality during pregnancy.

Placenta implanted in the lower uterine segment, partially or fully covering the cervical opening.

Marginal, Partial, Complete

Painless vaginal bleeding, often bright red, occurring in the late second or third trimester.

Premature separation of a normally implanted placenta from the uterine wall.

Painful vaginal bleeding, uterine tenderness, rigidity or frequent contractions.

Bleeding within the uterus, not visible externally.

Fetal blood vessels cross the membranes covering the cervical opening.

Painless bleeding, often after membrane rupture, associated with fetal distress or exsanguination.

Cervical ectropion, polyps, or carcinoma. Vaginal varices or trauma.

A tear in the uterine wall, often after a previous uterine surgery.

Severe abdominal pain, shock, fetal distress.

Cervicitis or vaginitis.

Maternal bleeding disorders such as thrombocytopenia or DIC.

Previous cesarean delivery, advanced maternal age, multiparity, uterine surgeries, smoking or substance use.

Hypertensive disorders, trauma or external cephalic version, PROM, smoking or cocaine use, previous history of abruption.

Low-lying placenta, multiple gestation, in vitro fertilization.

Painless, bright red bleeding, onset is sudden and often recurrent, uterus is non-tender and relaxed.

Painful, dark red bleeding, onset is sudden, may be associated with trauma or hypertension, uterus is rigid, tender with frequent contractions, fetal distress is common.

Painless bleeding associated with rupture of membranes, severe fetal distress, may lead to fetal exsanguination.

Bloody show (normal in labor), cervical or vaginal trauma, cervical ectropion or polyps, genital tract infections.

Gather information about the bleeding, associated symptoms, and risk factors.

Avoid vaginal examination unless placenta previa is ruled out.

Ultrasound to identify placenta previa or abruption, assess placental location, fetal viability and amniotic fluid volume.

Complete blood count (CBC), coagulation profile, blood group and crossmatch.

Non-stress test or biophysical profile to monitor fetal well-being.

Ensure airway, breathing, and circulation (ABC), IV access with large-bore cannulas, fluid resuscitation with crystalloids, transfuse blood products if required.

Continuous fetal heart rate monitoring.

Ultrasonography to confirm placental location and rule out previa or abruption.

Admit for observation, bed rest, and corticosteroids if gestation is less than 34 weeks.

Immediate cesarean section.

Immediate cesarean section.

Delivery of the baby.

Characterized by long-lasting, inflexible, extreme, and persistent patterns of behavior and inner experience, impacting self and relationships.

A diagnostic system grouping personality disorders into three clusters: odd/eccentric, dramatic/erratic, and anxious/fearful.

A personality disorder characterized by suspicion, distrust, and a belief that others intend to harm or deceive them.

A personality disorder characterized by detachment from social relationships, restricted emotional expression, and a lack of interest in activities.

A personality disorder characterized by odd beliefs, eccentric behavior, and difficulties with social interactions.

A personality disorder characterized by disregard for the rights of others, deceitfulness, impulsivity, and a lack of remorse.

A personality disorder marked by unstable relationships, intense emotions, impulsivity, self-harm, and a fear of abandonment.

A personality disorder characterized by excessive emotionality, a need for attention, and dramatic behavior.

A personality disorder characterized by a grandiose sense of self-importance, a need for admiration, and a lack of empathy.

A personality disorder characterized by avoidance of social situations, fear of criticism or rejection, and feelings of inadequacy.

A personality disorder characterized by a need to be taken care of, submissiveness, difficulty making decisions, and fear of separation.

A personality disorder characterized by a preoccupation with orderliness, perfectionism, control, and a lack of flexibility.

The tendency to focus on and exaggerate negative aspects of oneself and the world, leading to self-defeating behaviors.

A therapeutic approach for BPD, combining acceptance, empathy, and cognitive behavioral therapy.

A therapy for BPD that helps individuals develop better understanding of their emotions and those of others.

A therapeutic approach focusing on identifying and challenging core beliefs that contribute to BPD.

A brain region involved in processing emotions, particularly fear, anger, and sadness.

A neurotransmitter that plays a significant role in mood and behavior.

A theory that suggests BPD develops from a combination of biological vulnerability and an invalidating family environment.

A phenomenon in which individuals with BPD struggle to regulate their emotions, leading to intense reactions and difficulty controlling impulses.

A state of lacking empathy, understanding, or concern for others.

A personality trait characterized by a reduced capacity for experiencing fear and anxiety.

A personality trait marked by acting without thinking through the consequences.

The absence of guilt, remorse, or shame after wrongdoings.

A theory suggesting that narcissism stems from early childhood experiences where an individual seeks to increase their parent's self-esteem.

A model that explains narcissism as a coping mechanism for low self-esteem, using interpersonal relationships to boost self-worth.

The study of differences in personality traits and behaviors between individuals.

A condition that often co-occurs with another condition; multiple conditions occurring in the same person.

A form of therapy that helps individuals develop awareness and understanding of their thoughts, feelings, and behaviors.

A therapeutic approach that targets specific behaviors and thought patterns to address the symptoms of a disorder.

A type of medication designed to address mental health conditions, such as depression, anxiety, or schizophrenia.