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A Bishop's score 6 or less often indicates that induction (e.g., with controlled-release prostaglandin E2/prostin gel [Cervidil], intravaginal gel [Prostin], intracervical gel [Prepidil]) is unlikely to be successful. [5] Some sources indicate that only a score of 8 or greater is reliably predictive of a successful induction.
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.
Early pregnancy bleeding (also called first trimester bleeding) is vaginal bleeding before 14 weeks of gestational age. [ 1 ] [ 2 ] If the bleeding is significant, hemorrhagic shock may occur. [ 1 ] Concern for shock is increased in those who have loss of consciousness , chest pain, shortness of breath , or shoulder pain.
Implantation bleeding may be confused with a regular period. [5] [6] Heavy vaginal bleeding in the first trimester or bleeding associated with pain, may be a sign of a complication, such as a miscarriage or an ectopic pregnancy, that would need to be assessed by a healthcare provider. [7]
[6] [7] In children, it may be challenging to determine the source of bleeding, and "vaginal" bleeding may actually arise from the bladder or urethra, or from the rectum. [12] Vaginal bleeding in the first week of life after birth is a common observation, and pediatricians typically discuss this with new mothers at the time of hospital discharge.
Antepartum bleeding, also known as antepartum haemorrhage (APH) or prepartum hemorrhage, is genital bleeding during pregnancy after the 24th week of pregnancy up to delivery. [ 1 ] [ 2 ] It can be associated with reduced fetal birth weight. [ 3 ]
It is responsible for 8% of maternal deaths during childbirth in developed regions and 20% of maternal deaths during childbirth in developing regions. [7] Globally it occurs about 8.7 million times and results in 44,000 to 86,000 deaths per year making it the leading cause of death during pregnancy.
[8] [9] However, the case of intrauterine hematoma observed before 9 weeks of gestational age has been associated with an increased risk of miscarriage. [10] In one study women who complied with instructions for bed rest for the duration of bleeding had a lower rate of miscarriage and a higher rate of term pregnancy than non-compliant women.
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