antepartum hemorrhage

antepartum hemorrhage Bleeding from genital tract after 24weeks gestation but before onset of labor TYPES OF APH  Placenta praevia  Placenta abruption ASSESSMENT OF PHYSICAL CONDITION;  Maternal cx.  Assess emotional status  Pallor, breathlessness(indicate shock)  Observe pulse rate respiratory, blood pressure and temperatures  Assess amount of blood loss=ensure adequate fluid replacement  A gentle abdominal exam is done-observe signs of labour(N/B:-NO VAGINAL EXAM,NO RECTAL EXAM. NO ENEMAS TO BE DONE THEY CAN EXACERBATE BLEEDING) Fetal condition:  Fetal movements  Fetal heart rate  Ultrasound to confirm findings SUPPORTIVE TREATMENT Emotional reassurance Fluid replacement-plasma expanders Strong Analgesia for pain If woman is at home-arrangements should be made to transfer her to hospita