EmergenciesFree in the app
Antepartum haemorrhage
Bleeding from 24+0 weeks until birth.
Source: RCOG GTG 63 · GTG 27aGrade
| Spotting | Streaks on pad. |
|---|---|
| Minor | <50 ml, settled. |
| Major | 50–1000 ml, no shock. |
| Massive | >1000 ml and/or shock. |
Act
- Call for help; ABC; left lateral.
- Two cannulas; FBC, clotting, crossmatch, Kleihauer if RhD-negative.
- No vaginal exam until placenta praevia excluded.
- CTG; steroids if 24–34+6 weeks and birth likely.
- Massive or fetal compromise: deliver (usually CS).
Painless bright bleed → praevia. Pain, hard uterus, shock out of proportion → abruption. Bleed at ROM with fetal distress → vasa praevia.
A summary for trained clinicians. Always check the full guideline, the patient in front of you and your hospital's protocol. Spotted an error? Tell us.