ABSTRACT
For each of the following scenarios, select the most likely cause of antepartum haemorrhage. Each option may be used once, more than once or not at all.
1. A 34-year-old woman is labouring well at term with an epidural in situ. She has reached 8 cm of cervical dilatation with good progression. Since insertion of the epidural, she has felt no contractions. Suddenly, she experiences severe lower abdominal pain associated with vaginal bleeding and tachycardia. The cardiotocograph (CTG) does not detect any contractions and shows signs of significant fetal distress. She has had three previous pregnancies, including two spontaneous vaginal births and one caesarean section for failure to progress.
