{"id":171,"date":"2015-12-09T15:33:00","date_gmt":"2015-12-09T15:33:00","guid":{"rendered":"http:\/\/brooksidepress.org\/ob-ped\/?page_id=171"},"modified":"2023-08-20T22:06:31","modified_gmt":"2023-08-20T22:06:31","slug":"2-22-antepartum-hemorrhage","status":"publish","type":"page","link":"https:\/\/brooksidepress.org\/ob-ped\/lessons\/lesson-2-normal-and-emergency-childbirth\/section-v-complications-of-labor-and-delivery\/2-22-antepartum-hemorrhage\/","title":{"rendered":"2-22. ANTEPARTUM HEMORRHAGE"},"content":{"rendered":"<p>a.<strong> Definition\/Causes<\/strong>. Antepartum hemorrhage is the patient hemorrhaging\u00a0before delivery.<\/p>\n<p>Three major causes of this condition are placenta abruptio, placenta\u00a0previa, and uterine rupture.<a href=\"https:\/\/brooksidepress.org\/ob-ped\/wp-content\/uploads\/2016\/12\/Abruption-1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-431 size-medium alignright\" src=\"https:\/\/brooksidepress.org\/ob-ped\/wp-content\/uploads\/2016\/12\/Abruption-1-209x300.jpg\" alt=\"\" width=\"209\" height=\"300\" title=\"\"><\/a><\/p>\n<p style=\"padding-left: 30px;\">(1) Placenta abruptio. In this condition, the placenta separates from the wall\u00a0of the uterus. The separation usually occurs during the last two months of pregnancy.<\/p>\n<p style=\"padding-left: 30px;\">When the placenta separates from the uterine wall, placenta blood vessels rupture, and\u00a0spontaneous bleeding starts. The mother may go into shock, and the fetus may not\u00a0have enough oxygen. Signs of this condition include abdominal pain and rapid onset of\u00a0labor. The uterus becomes rigid. To treat, transport the mother immediately to a\u00a0hospital and treat for shock.<\/p>\n<p><a href=\"https:\/\/brooksidepress.org\/ob-ped\/wp-content\/uploads\/2016\/12\/previa.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-421 size-medium alignright\" src=\"https:\/\/brooksidepress.org\/ob-ped\/wp-content\/uploads\/2016\/12\/previa-206x300.jpg\" alt=\"\" width=\"206\" height=\"300\" title=\"\" srcset=\"https:\/\/brooksidepress.org\/ob-ped\/wp-content\/uploads\/2016\/12\/previa-206x300.jpg 206w, https:\/\/brooksidepress.org\/ob-ped\/wp-content\/uploads\/2016\/12\/previa.jpg 242w\" sizes=\"auto, (max-width: 206px) 100vw, 206px\" \/><\/a><\/p>\n<p style=\"padding-left: 30px;\">(2) Placenta previa. Here, the presenting part is the placenta. Since the\u00a0placenta has many blood vessels, a massive hemorrhage may occur.<\/p>\n<p style=\"padding-left: 30px;\">(3) Uterine rupture. A uterine rupture is a tearing of a part of the uterus.\u00a0The patient has sudden, severe abdominal pain, and a rigid abdomen. Bleeding may\u00a0not be apparent externally, but the patient can have profound shock from internal\u00a0hemorrhage.<\/p>\n<p><em><strong>CAUTION: DO NOT attempt to examine the patient internally, regardless of the\u00a0cause of antepartum hemorrhage.<\/strong><\/em><\/p>\n<p>b. <strong>Management of Antepartum Hemorrhage<\/strong>. Manage as follows:<\/p>\n<p style=\"padding-left: 30px;\">(1) Place the patient flat on a stretcher, lying on her side.<\/p>\n<p style=\"padding-left: 30px;\">(2) Administer oxygen to the patient.<\/p>\n<p style=\"padding-left: 30px;\">(3) Start at least two large-bore IV lines. Give crystalloid or colloid as\u00a0rapidly as needed to maintain the patient&#8217;s blood pressure.<\/p>\n<p style=\"padding-left: 30px;\">(4) To treat for shock, it may be necessary to apply a MAST garment. If so,\u00a0inflate the leg sections only of this garment.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>a. Definition\/Causes. Antepartum hemorrhage is the patient hemorrhaging\u00a0before delivery. Three major causes of this condition are placenta abruptio, placenta\u00a0previa, and uterine rupture. (1) Placenta abruptio. In this condition, the placenta separates from the wall\u00a0of the uterus. The separation usually occurs during the last two months of pregnancy. When the placenta separates from the uterine wall, &hellip; <a href=\"https:\/\/brooksidepress.org\/ob-ped\/lessons\/lesson-2-normal-and-emergency-childbirth\/section-v-complications-of-labor-and-delivery\/2-22-antepartum-hemorrhage\/\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">2-22. ANTEPARTUM HEMORRHAGE<\/span> <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"parent":36,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-171","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/brooksidepress.org\/ob-ped\/wp-json\/wp\/v2\/pages\/171","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/brooksidepress.org\/ob-ped\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/brooksidepress.org\/ob-ped\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/brooksidepress.org\/ob-ped\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/brooksidepress.org\/ob-ped\/wp-json\/wp\/v2\/comments?post=171"}],"version-history":[{"count":4,"href":"https:\/\/brooksidepress.org\/ob-ped\/wp-json\/wp\/v2\/pages\/171\/revisions"}],"predecessor-version":[{"id":555,"href":"https:\/\/brooksidepress.org\/ob-ped\/wp-json\/wp\/v2\/pages\/171\/revisions\/555"}],"up":[{"embeddable":true,"href":"https:\/\/brooksidepress.org\/ob-ped\/wp-json\/wp\/v2\/pages\/36"}],"wp:attachment":[{"href":"https:\/\/brooksidepress.org\/ob-ped\/wp-json\/wp\/v2\/media?parent=171"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}