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Chapter-02 Antepartum Hemorrhage

BOOK TITLE: Ward Rounds in Obstetrics and Gynecology

Author
1. Doshi Haresh U
ISBN
9789352702398
DOI
10.5005/jp/books/18053_3
Edition
1/e
Publishing Year
2018
Pages
11
Author Affiliations
1. Medical College, Ahmedabad, BJ Medical College and Civil Hospital, Ahmedabad, Gujarat, GCS Medical College, Hospital and Research Center, Ahmedabad, Gujarat, India
Chapter keywords
Antepartum hemorrhage, placenta previa, abruptio placentae, placental migration, cesarean section, postpartum hemorrhage, disseminated intravascular coagulation, Couvelaire uterus, tocolysis

Abstract

Written in question and answer format, this chapter presents a brief discussion on antepartum hemorrhage (APH). APH is defined as bleeding from or into the genital tract after 28 weeks of pregnancy till delivery of fetus. It complicates 3–5% of pregnancies and is a leading cause of perinatal and maternal mortality worldwide. Placenta previa is classified into low-lying, marginal, incomplete, and complete. McAfee Johnson expectant treatment is continuation of pregnancy after bleeding stops. It includes hospitalization and bed rest. After bleeding stops gentle speculum examination is carried out to exclude vaginal and cervical bleeding and USG-TVS confirms the diagnosis of placenta previa. Placenta accreta should always be managed at tertiary care level institute by multidisciplinary approach. Cesarean section remains the safest option in all types of moderate to severe APH.

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