ANTI-PARTUM

HAEMORRHAGE
PRESENTED BY MAPHATHE
Learning outcome
Define /Explain Anti-Partum
Haemorrhage
Describe the causes of Anti-Partum
Haemorrhage
Describe it’s risk factors
Describe it’s signs and symptoms
Explain the complications of Anti-Partum
Haemorrhage
Definition
It is the vaginal bleeding during
pregnancy after 24 weeks of gestation
whose cause may be placenta praevia
or abruptio placenta
Causes of Anti-Partum Haemorrhage
Placenta praevia; Bleeding occurs from
an abnormal situated placenta. In
placenta praevia bleeding is revealed
with the blood bright red.
The placenta praevia has it’s
grades ,which are type one ,type
two ,type three and type four.
Cont...
Type one placenta praevia
The majority of the placenta is in the upper uterine
segment.
Vaginal delivery is possible.
Blood loss is usually mild and the mother and the
fetas remain in good condition.
Type two placenta praevia
The placenta is partially located in the lower segment
near the internal cervical os(marginal placenta
praevia)
Vaginal delivery is possible ,particularly if the placenta
is anterior.
Blood loss is usually moderate ,although the condition
of the mother and the fetus can vary
Type three placenta praevia
The placenta is located over the internal cervical os but
not centrally.
Bleeding is likely to be severe ,particularly when the
lower segment stretches and the cervix being to efface
and dilate in late pregnancy.
Type four placenta praevia

The placenta is located centrally over the internal

cervical os and torrential haemorrhage is very likely.
Caesarean section is essential in other to save the lives
of the mother and the fetus
Risk factors of placenta praevia
Multiple pregnancy
Multiparity
Tumour scaring the endometrium
The signs and symptoms of placenta
praevia
Scanty or heavy bright red coloured
painless blooding
Pale looking patient, the degree of which
corresponds to the amount of blood loss.
No tenderness in the uterus
The presenting part may be high
Malpresentation
Cont...
The fetal parts are easily palpable
The fetal heart sounds are usually
present
Abruptio Placenta
This is premature separation of the
normal situated placenta with the
resultant retro placenta
bleeding ,which can be consealed or
revealed type.
Types of Abruptio placenta
Explanation of Revealed type and
Concealed type
Revealed type ,the amount of external blood loss is
consistent with the condition of the patient.
Concealed type, there is usually little or no visible
vaginal bleeding ,yet the patient is pale.
The risk factors are
Hypertension
Trauma
Sudden uterine decompression(short
umbilical cord)
Multiparity
Cont...
Previous abruption placenta
Multiple pregnancy
Poly hydramnios
Malnutrition in pregnancy
Signs and symptoms of Abruptio Placenta
Constant abdominal pain
Tender abdomen
Woody hard, tense uterus
Contractions
Fetal sounds are absent in severe casas
Complications of Anti-Partum
Haemorrhage
Maternal shock, resulting from blood loss and
hypovolaemia
Anaesthetic and surgical complications , which are
more common in women with major degrees of
placenta praevia , and in those for whom preparation
for surgery has been suboptimal
Maternal death
Management of Anti Partum
Haemorrhage{Placenta Praevia}
Avoidance of coitus and vaginal examination
Counseling to seek immediate medical attention if
there is any vaginal bleeding
Transfer the woman to the hospital immediately