OBJECTIVES
Identify the major causes of third trimester bleeding
Identify the steps needed to evaluate a patient with an antepartum hemorrhage
Discuss the management of a patient with a third-trimester bleeding
Ante partum Hemorrhage
Obstetrics is "bloody business."
Death from hemorrhage still remains a leading cause of maternal mortality.
Hemorrhage was a direct cause of more than 18 percent of 3201 pregnancy-related maternal deaths.
BACKGROUND
Non-pregnant state: uterus receives 1% of cardiac output
Plasma volume increases by 50%
COP increases by 30-50%
Third trimester: uterus receives 20% of an increased output
Real potential for massive hem.
Third trimester bleeding occurs in approximately 4% of patients.
Approximately 50% will have an inconsequential cause and 50% will have a life-threatening event.
Power point presentation for 6th year medical student