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ANTE-PARTUM HAEMORRAGE (APH)

ANTE-PARTUM HAEMORRAGE (APH). WONGANI ZGAMBO ARNOLD MKANDAWIRE DANIEL LEVITICUS. OBJECTIVES. By the end of this session participant should be able to Define the term APH. Explain the causes of APH. Describe the clinical presentation of APH Outline the management of APH. DEFINITION OF APH.

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ANTE-PARTUM HAEMORRAGE (APH)

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  1. ANTE-PARTUM HAEMORRAGE (APH) WONGANI ZGAMBO ARNOLD MKANDAWIRE DANIEL LEVITICUS

  2. OBJECTIVES • By the end of this session participant should be able to • Define the term APH. • Explain the causes of APH. • Describe the clinical presentation of APH • Outline the management of APH

  3. DEFINITION OF APH .Bleeding from vagina at least at 22 weeks or more of pregnancy.

  4. CAUSES • Many causes the major causes are • 1– placenta previa • 2-Abruptionlplacenta

  5. EXAMPLES OF PLACENTA ABRUPTUAL

  6. CLINICAL PRESENTAION • PLACENTA ABRAPTUAL • Uterus is tender and hard(couvelaire uterus) • Heavy bleeding lead to hypovolemic shock. • PLACENTA PREVIA • Painless vaginal bleeding.

  7. RISK FACTORS • Previous C/s scar • Uterine abnormality • Previous curettage • Multiparity • Multiple pregnancy

  8. MANAGEMENT OF APH • Admit the patient • Management follow the ABC principle • If severe bleeding • Iv line ringers lactate or N/S • Grouping and X-match • Delivery irrespective of the gestation age usually c/s.

  9. MANAGEMENT CONT…… • LIGHT BLEEDING/ BABY PREMATURE • Keep the woman in hospital until delivery • Correct anaemia • Ensure blood is available for transfusion if required

  10. INVESTIGATIONS • USS • Haemoglobin level. • Grouping and cross match.

  11. COMPLICATION OF APH • Disseminated intravascular coagulation • Haemorrhagic shock which can lead to death. • Convulaire uterus which can lead to hysterectomy • Premature delivery/ FSB

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