antepartum haemorrhage (APH)
• Bleeding in to genital track often period of viability till delivery
• Causes
Abruptio placenta
Placenta previa
Vasa previa
Vasa previa
- It is a complication of pregnancy in which fetal blood vessals cross or near the internal cervical os.
- These vessels are at risk of rupture when supporting membranes rupture, as they are unsupported by the umbilical cord or placental tissue
Risk factors
- velamentous insertion of the umbilical cord
- The blood vessels are attached to the amnion, where they divide before reaching the plecenta
- multiple gestation
- IVF pregnancy
- Apt test / alkali denaturation test / singers test Fetal blood (Hb FT) is resistant to alkaine ph.
Management
- In this condition delivery conducted by Cesarean section
RUPTURE OF THE UTERUS
- separation of the uterine tissue as a result of a tear in the wall of the uterus from the stress of labor
Risk factors
- Previous cesarean
- Over distended uterus
- trauma
Clinical presentation
- Abdominal pain or tenderness
- Chest pain
- Contractions may stop or fail to progress
- Rigid abdomen
- Absent fetal heart rate
- Signs of maternal shock
- Fetus palpated outside the uterus (if complete Rupture )
- Vaginal bleeding
- Monitor t signs of shock ( administer oxygen, intravenous fluids, and blood products).
- Prepare client for cesarean delivery (possible hysterectomy may be necessary).
- Provide emotional support for the client and partner.
- Link - abruptio placenta
- Link- placenta previa
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