Antepartum haemorrhage (APH) refers to vaginal bleeding during the second half of pregnancy (>20 weeks gestation). Antepartum haemorrhage may occur in varying degrees from mild to severe, with concomitant risk to the mother and fetus and potentially result in severe maternal/fetal compromise, including death.
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Epidemiology
It complicates 3-5% of all pregnancies 3. Antepartum haemorrhage is associated with an increased risk of postpartum haemorrhage.
Pathology
Aetiology
Causes include:
placenta praevia (20% of all APH)
vasa praevia (rarest cause of haemorrhage in pregnancy 3)
cervical or genital tract bleeding