Antepartum Haemorrhage | Aph.ppt !full!

The lower uterine segment stretches significantly in the third trimester. In placenta praevia, the placental attachment cannot stretch, leading to shearing and bleeding from the maternal decidua.

In roughly 5-10% of cases, the cause of APH remains unexplained even after thorough investigation. This is often termed "unclassified APH." It may be due to marginal placental separation or vasa praevia (rare but critical). Antepartum haemorrhage APH.ppt

| Feature | Placenta Praevia | Placental Abruption | | :--- | :--- | :--- | | | Painless | Painful (severe, continuous) | | Bleeding | Bright red, fresh | Dark red/clotted | | Uterus | Soft, non-tender | Rigid, tender, "woody" | | Fetal Heart | Usually normal initially | Often abnormal or absent | | Shock | Proportionate to blood loss | Often out of proportion to visible loss | | Coagulopathy | Rare | Common (DIC) | The lower uterine segment stretches significantly in the

When structuring an , the most logical approach is to categorize the etiology. The causes are traditionally grouped into three main categories, often referred to as the "3 Ps" plus "Others." This is often termed "unclassified APH

Cervical lesions (polyps, cancer), vaginal trauma, or infections.

Premature separation of a normally situated placenta from the uterine wall before delivery.