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Antepartum bleeding (APH), also prepartum hemorrhage, is bleeding during pregnancy from the 24th week [7] (sometimes defined as from the 20th week [8] [7]) gestational age up to the birth of the baby. [5] The primary consideration is the presence of a placenta previa which is a low lying placenta at or very near to the internal cervical os.
It is the most common cause of early pregnancy bleeding and is associated only with heavy (versus light) bleeding. [8] However, patients typically remain hemodynamically stable. Threatened early pregnancy loss, often considered a type of early pregnancy loss, refers vaginal bleeding in the presence of an intrauterine pregnancy and a closed cervix.
Symptoms include vaginal bleeding, abdominal pain, premature labor and threatened miscarriage. [6] Ultrasonography is the preferred method of diagnosis. [7] A chorionic hematoma appears on ultrasound as a hypoechoic crescent adjacent to the gestational sac. The hematoma is considered small if it is under 20% of the size of the sac and large if ...
Hormone levels, bleeding, a positive pregnancy test and an ultrasound of an empty uterus all indicate an ectopic pregnancy. “You can't be 100% — that's the tricky part," said Kate Arnold, an ...
The sex of the fetus may be discerned by ultrasound as early as 11 weeks' gestation. The accuracy is relatively imprecise when attempted early. [15] [16] [17] After 13 weeks' gestation, a high accuracy of between 99% and 100% is possible if the fetus does not display intersex external characteristics. [18]
[35] [36] [37] Bleeding can be a symptom of miscarriage, but many women also have bleeding in early pregnancy and do not miscarry. [38] Bleeding during the first half of pregnancy may be referred to as a threatened miscarriage. [39] Of those who seek treatment for bleeding during pregnancy, about half will miscarry. [40]
An important risk factor for placenta accreta is placenta previa in the presence of a uterine scar. Placenta previa is an independent risk factor for placenta accreta. Additional reported risk factors for placenta accreta include maternal age and multiparity, other prior uterine surgery, prior uterine curettage, uterine irradiation, endometrial ablation, Asherman syndrome, uterine leiomyomata ...
A hematosalpinx from a tubal pregnancy may be associated with pelvic pain and uterine bleeding. A gynecologic ultrasound will show the hematosalpinx. A hematosalpinx from other conditions may be painless but could lead to uterine bleeding.
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