Maternal Care: Antepartum Haemorrhage (APH)

Study Notes

Placenta praevia is defined as the placenta being implanted in the lower uterine segment, partially or completely covering the internal cervical os.
Bleeding in placenta previa is usually painless and bright red.
The objective of speculum examination in placenta previa is to visualize the cervix and confirm the presence of bleeding.
Grade 4 placenta previa, where the placenta completely covers the internal cervical os, requires a Caesarean section. This is a primary reason for the procedure.
Conservative management of placenta previa involves strict bed rest and close monitoring.
The most critical aspect of conservative management is patient education and adherence to instructions.
Prompt hospital referral is crucial for life-threatening cases.
Re-evaluation at the hospital is necessary to assess the ongoing bleeding, fetal condition, and maternal vital signs.

Placenta abruptio is defined as the premature separation of a normally implanted placenta from the uterine wall.
The primary complication of placenta abruptio is fetal distress, which can be severe and life-threatening.
Maternal complications of placenta abruptio include hemorrhage and disseminated intravascular coagulation (DIC). These can lead to maternal death.
Early identification and management of fetal distress are crucial in placenta abruptio.
Emergency delivery, typically by Caesarean section, is often necessary.
The first step in managing life-threatening placenta previa at a clinic or community health centre is to stabilize the mother and fetus and refer to a tertiary hospital with adequate resources.