ABSTRACT
Antepartum haemorrhage is variously described as bleeding from the genital tract in pregnancy before the onset of labour at gestations from 20 to 24 weeks. The bleeding is said to be painless, though a considerable number of women who bleed from a placenta praevia will have a coexistent abruption. It is also reported that most women experience a minor bleed before any major bleeding. Death of a woman from haemorrhage at elective caesarian section has been defined by the national patient safety agency as a ‘never event’. Antepartum haemorrhage increases the risk of perinatal death regardless of the cause. The surgeon should have a clear idea of the views of the woman regarding management in the face of haemorrhage with regard to uterine preservation or hysterectomy. Women delivered with a major placenta praevia or who have had significant intraoperative haemorrhage must be carefully monitored in a high-dependency setting until continuing loss has been excluded.
