Medicine an Surgery notes

Apr 24th, 2015
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ANTEPARTUM HEMORRHAGEDefinition:It is bleeding per vagina after 28th week of pregnancy also known as third trimester bleedingEtiology:Differentiation must be made between obstetric causes of bleeding (usually more hazardous) and nonobstetric causes (usually less hazardous) Obstetric causesa) Placenta previab) Abruptio placentac) Vasa previad) Bloody showe) Uterine rapturef) Disseminated Intravascular CoagulopathyNonobstetric causesa) Cervicitisb) Cervical cancer or dysplasiac) Cervical polypsd) Cervical eversione) Cervical erosionf) Vaginal lacerationg) Vaginitish) Vaginal varicositiesi) Vaginal trauma E.g. sexual, objectNonobstetric causes usually result in relatively little blood loss and little threat to mother or fetus. An exception is invasive carcinoma of the cervix.Most serious hemorrhages (2-3% of pregnancies) lose more than 800mL of blood and are due to premature separation of the placenta or placenta previa. Less common but still dangerous causes of bleeding are circumvallate placenta, abnormalities of the blood clotting mechanism, and uterine ruptureBleeding from the peripheral portion of the intervillous space, or marginal sinus rupture,

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