Causes of APH

The major causes of APH are placenta praevia, abruptio placentae, local causes, and indeterminate bleeding. Placenta praevia defines as low lying placenta which mean the placenta is located near the uterine opening.It causes uterine bleeding following separation of low-lying placenta from the lower segment of the uterus. The bleeding is from the maternal and not fetal circulation and is more likely to compromise the mother than the fetus (as opposed to that of placenta abruption which prone to compromise fetal circulation). The amount of bleeding in placenta praevia varies from one patient to another. It can range from a mere spotting to torrential bleeding that is life threatening.

Introduction

Antepartum haemorrhage APH is defined as bleeding from genital tract between the period of fetal viability to the onset of the labour. Traditionaly the period is taken from 28 weeks onwards. But with the now accepted period of viability starting at 22 weeks, the definition has been changed accordingly. Any bleeding that occurs before that period is usually due to some form of abortion. Because it is important contributor to both perinatal and maternal deaths, it is very important to manage APH well.