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  • Ante-Partum Haemorrhage: Ed Management

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    Shane Lambert
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    This document provides guidance on the management of ante-partum haemorrhage (bleeding after 24 weeks of gestation). It outlines that the most common cause is mild bleeding from cervical injury or ectropion during intercourse. It emphasizes to never perform a vaginal exam without first ruling out placenta praevia. For emergency department management, it lists steps to take including calling for help, IV access, blood tests, activating major haemorrhage protocol, and fluid/blood product resuscitation before referral for assessment. It describes placenta praevia as the placenta covering or encroaching on the cervical os, typically painless with no concealed bleeding but risk of sudden major haemorrh

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    This document provides guidance on the management of ante-partum haemorrhage (bleeding after 24 weeks of gestation). It outlines that the most common cause is mild bleeding from cervical injury or ectropion during intercourse. It emphasizes to never perform a vaginal exam without first ruling out placenta praevia. For emergency department management, it lists steps to take including calling for help, IV access, blood tests, activating major haemorrhage protocol, and fluid/blood product resuscitation before referral for assessment. It describes placenta praevia as the placenta covering or encroaching on the cervical os, typically painless with no concealed bleeding but risk of sudden major haemorrh

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    5 views1 page

    Ante-Partum Haemorrhage: Ed Management

    Uploaded by

    Shane Lambert
    This document provides guidance on the management of ante-partum haemorrhage (bleeding after 24 weeks of gestation). It outlines that the most common cause is mild bleeding from cervical injury or ectropion during intercourse. It emphasizes to never perform a vaginal exam without first ruling out placenta praevia. For emergency department management, it lists steps to take including calling for help, IV access, blood tests, activating major haemorrhage protocol, and fluid/blood product resuscitation before referral for assessment. It describes placenta praevia as the placenta covering or encroaching on the cervical os, typically painless with no concealed bleeding but risk of sudden major haemorrh

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 1

    ANTE-PARTUM HAEMORRHAGE

    Bleeding ≥ 24/40 gestation


    Most commonly mild bleeding with intercourse (cervical injury/ectropion)

    Never perform a vaginal exam without first excluding placenta praevia


    ‘no PV until no PP’

    ED MANAGEMENT
    Call for help
    ABC resuscitation
    Large bore IV access x2
    Bloods + Group and Cross-Match
    Low threshold for major haemorrhage protocol
    Fluid/blood product resuscitation
    Refer all for assessment

    PLACENTA PRAEVIA
    • Placenta encroaching on/covering the os
    • Typically painless
    • Generally no concealed bleeding
    • Risk of sudden, unpredictable, major haemorrhage

    PLACENTAL ABRUPTION
    • Premature separation of placenta due to bleeding
    • Blood can be ‘concealed’ within uterus
    • Significant pain, uterine tenderness and maternal shock
    may indicate major concealed haemorrhage

    OTHERS
    VASA PRAEVIA
    Umbilical vessels, lacking Wharton’s jelly, between baby and cervix
    UTERINE RUPTURE
    GRI ED
    From previous C-Section or uterine surgery Sept 2016

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