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Antepartum haemorrhage — abruption or praevia 🚨 🤰
Antepartum haemorrhage — abruption or praevia 🚨 🤰
Placental abruption can cause concealed maternal haemorrhage and fetal hypoxia, whereas praevia classically causes painless bleeding; either may deteriorate rapidly.
🔎 Recognise
Bleeding after 24 weeks, pain or uterine tenderness, contractions, reduced fetal movements, hypotension or collapse warrants immediate maternity assessment.
🛟 First actions
Call the obstetric emergency team, assess ABCDE and activate major haemorrhage support if unstable. Assess maternal physiology and ensure simultaneous fetal assessment by the maternity team.
🧪 Investigations and reassessment
Group and crossmatch, full blood count and coagulation/fibrinogen investigations should follow the obstetric haemorrhage protocol. Ultrasound helps identify placental location but does not reliably exclude abruption.
⚠️ Common pitfalls and escalation
Do not perform a digital vaginal examination until placenta praevia has been excluded by the obstetric team. Visible blood loss can substantially underestimate concealed abruption.
UK reference: RCOG Green-top 63. Focused editorial source check, 7 November 2026; this is not independent clinical or pharmacy sign-off. Verify current local policy, BNF/BNFC and specialist advice before treatment. Not a prescribing protocol.
Related guides: Bleeding Antepartum · Postpartum haemorrhage — FY quick guide 🚨 🩸
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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