Antepartum Haemorrhage

Most of this guideline is aimed at secondary care. From our point of view:

  • Any bleeding, including spotting needs evaluation in secondary care, even if painless.
  • Beware cervical lesions as a cause, especially in women with a history of abnormal smears – if in doubt refer to colposcopy.
  • Placenta Praevia – don’t do a VE, speculum exam or rectal exam if there is a known placenta praevia.
  • Women who’ve had a major APH should have a postnatal consultation with a consultant at around 8/52 to discuss what happened and their future risk. They may also be sent home with post-natal thromboprophylaxis as it is a VTE risk factor.

Louise Hudman

I'm a freelance GP locum in Winchester & Southampton.

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