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Ante-partum haemorrhage (Aetiology (Infection/inflammatrion Vaginitis,…

- - - - Examination
        General - cyanosis/shock
        Uterine - size, tenderness, foetal lie, presenting part
        DO NOT do a PV exam until PP excluded
      - Investigations
        Bedside - obs (BP, HR), ECG, fetal monitoring (HR)
        Imaging - transvaginal USS (locate placenta)
      - History
        PC/HPC: amount of blood, pain
        PMH: prev surgeries e.g. CS
        Gestational history: gest age, placenta position, prev bleeds
        Obstetric history: abruption, placenta praeva
        SH: smoking, alcohol, illicit drugs
  - - - History
        PC/HPC: sudden abdo pain, bleeding
      - Examination
        General: signs of shock
        Uterine: tender, uterine activity, hard; PV bleeding
        Foetal: signs of distress
      - Investigations
        USS (foetus, exclude praeva)
        Cardiotocography (foetal HR, contractions)
    - - Initial ABCDE
      - Definitive
        Admit if unexplained abo pain or PV bleed
        If foetal distress/maternal compromise, deliver
        If no foetal distress and mother resus, consider wait until term
    - - Maternal factors
        Increased age
        Thrombophilia
      - Lifestyle
        Smoking
        Cocaine/amphetamines
      - Foetal factors
        Polyhydraminos
        Intrauterine growth retardation
      - Infection
      - Pregnancy factors
        Assisted pregnancy
        Multiple pregnancy
        Pre-eclampsia
        Preterm rupture of membranes (PROM)