Antepartum Haemorrhage(APH)

 Antepartum Haemorrhage (APH):

• defined as bleeding from or in to the genital tract, occurring from 24+0 weeks of pregnancy and prior to the birth of the baby. 

Clinical Features:

• 1)vaginal bleeding
• 2)abdominal pain
• 3)uterine contractions 
• 4)painless

Investigations:

• 1)Usg of P/P
• 2) CBC 
• 3)blood grouping & Rh typing 

📋Rx:

• Diet: N ( if pt stable)
  
• NPO ( if unconscious)
•  Absolute bed rest
• Continuous catheterization

1. Inf H/S (1L) + 5% DA+ 5%DNS

• I/V @30d/min
  

2. Inj.Tranexamic acid(xamic)(500mg) 

• 1amp I/V stat & tds

3. Inj.cephradine(Lebac/cephradl(500mg)

• 1 vial I/ V stat & 6 hrly

4.Inj.omeprazole(seclo/PPI) (40mg)

• 1 vial I/V stat & bd

5.Inj.prolution depot/HPC

• 1 amp I/M. weekly for....... 1 month

If Lower abdominal pain:

Inj.Tiemonium methylsulfate(viset/algin)

• 1 amp I/M stat & bd

For fetal lung maturity :

Inj.Dexamethasone (Oradexon )

•  2.5 amp I/ M stat & 2nd dose after 12 hrs 1st dose

If severe anaemia :

• Fresh humam blood