Antepartum hemorrhage 產前出血
Antepartum hemorrhage 產前出血
Vaginal bleeding during pregnancy is an indication of abnormal pregnancy. To avoid endangering mother and fetus, a thorough examination is necessary to uncover the cause regardless the amount of blood discharged.
Reasons of antenatal bleeding
- Abnormal placenta and uterus
- placenta previa
- low-lying placenta: most patients suffer from mild conditions, and rarely are there severe conditions.
- marginal blood vessel rupture
- early placenta separation
- Vasa previa : bleeding often occurs during delivering babies; the condition is often accompanied by low-lying placenta.
- Uterine rupture
- Cervix and vagina disease:
- cervix : including symptoms like erosion, polyp, and cancer
- vagina : including symptoms like trauma, varicosis, and foreign object
- Urogenital infection
- Hematology's disease
- Abortion : vagina bleeding with lower abdomen pain
- Ectopic pregnancy : Symptoms include sudden lower abdomen pain, menstrual period overdue, vagina bleeding, pale face, and fast pulse. Once there is fallopian tube rupture, patients could suffer from acute internal bleeding.
- Molar pregnancy: during early trimesters, it is almost impossible to distinguish it from the normal pregnancy; by 7-8 weeks of the trimester, patients start to have vagina bleeding, anemia, and over distended uterus. There is no sign of fetal heartbeat but all kinds of symptoms of pregnancy.
- Placenta previa : 7 months after the pregnancy, patients could suffer from sudden painless vaginal bleeding.
- Early placenta separation : symptoms include vagina bleeding, acute abdomen pain, drop of blood pressure, and increase of pulse rate.
- Sign of abortion : attend to bed-rest; intake oral or intramuscular progesterone.
- Incomplete abortion : use uterine contraction agents or uterus curettage.
- Complete abortion : observation and follow-up check
- Ectopic pregnancy : Physicians often undergo conservative observation base on patients’ condition and willingness. The method of the surgery is either laparoscopy or open-method, surgeons undergo laparoscopic salpingostomy or salpingectomy base on patients’ condition.
- Molar pregnancy : Molar pregnancy can be treated with uterine curettage. 20% molar pregnancy will develop into malignant tumor; therefore, long-term follow-up checks are required and pregnancy should be avoided for one year.
- Placenta previa : It can be treated base on the degree of severity, gestational weeks, and mother and fetal condition.
- Early placenta separation: For mild or uncertain cases, doctors often ask patients to attend to plenty of bed-rest, to stay calm, and to be supervised under careful observation. Immediate delivery is recommended when patients are diagnosed of early placenta separation.