Antepartum hemorrhage is vaginal bleeding during pregnancy caused by placenta difficulties. It can be painless or accompanied by pain and discomfort. Hospitalization and ultrasound are used to treat it, and blood transfusions may be necessary. Placenta previa and accreta are common causes, and timely treatment is crucial to reduce mortality risk.
An antepartum hemorrhage is vaginal bleeding that occurs during the next pregnancy until birth. It is commonly caused by difficulties with the placenta attaching to the uterus leading to tissue tearing or rupture. Depending on the underlying cause, it may be painless or accompanied by pain and discomfort. Like similar obstetric complications, antepartum hemorrhage is treated cautiously with ultrasonography and hospitalization of the mother. Blood transfusions can be applied in case of prolonged bleeding.
Obstetrical bleeding is a relatively common complication of pregnancy. Antepartum hemorrhages can indicate any vaginal bleeding that occurs later in the pregnancy, after the 24th week of gestation. About 30% of maternal mortality in pregnancy is related to antepartum hemorrhage, so an ultrasound examination is given to pregnant women with bleeding during late pregnancy to be safe. Hospitalization is important, because if blood pressure drops and bleeding returns, transfusion is sometimes needed to keep the mother stable. Even moderate bleeding can be fatal to the fetus if left untreated.
Placenta previa is a common cause of antepartum hemorrhage. Like most second and third trimester bleeding, it is more common in women who have had multiple pregnancies and/or cesarean sections. In this condition, the placenta improperly covers or tears away from the lower segment of the uterus, obstructing the cervix. This leads to vaginal bleeding and impedes the normal path of the fetus to the birth canal, necessitating a cesarean section. The goal of medical treatment is to keep the situation stable until 36-37 weeks, when surgical delivery is possible.
Placenta accreta induces vaginal bleeding through a complication where the placenta becomes deeply embedded in the wall of the uterus. Previous conditions of placenta previa and cesarean section increase the risk of placenta accreta, as does cigarette smoking. Removing the placenta is very difficult and can tear the uterus, causing immediate and rapid bleeding. Successful treatment focuses on minimizing complications for the mother and fetus by scheduling a cesarean section, which is often accompanied by a hysterectomy.
Premature rupture of the placenta from the uterus is a rarer cause of antepartum hemorrhage. Sometimes vaginal bleeding occurs in late pregnancy from sources other than the uterus or placenta, such as injury to the cervix. During the onset of labor, vaginal bleeding is relatively common. There is no way to directly prevent placenta accreta or placenta previa, but their risk factors, such as smoking and uterine scarring, can be reduced. Timely treatment of anemia, hypovolemia, and related bleeding complications greatly reduces the risk of mortality.
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