ABSTRACT
Antepartum haemorrhage (APH) may be due to a variety of causes and the most important initial response by the doctors and nurses involved must be to attempt to ascertain which is most likely. The differential diagnosis is between: • bleeding from a low lying placenta or placenta praevia; • bleeding from a normally sited placenta, that is, one in the upper part of
the uterus. This involves the separation of the placenta from the uterus wall and is known as a placental abruption;
• bleeding from a local cause in the lower genital tract. Most commonly, this will be infection, but the risk of cancer must always be borne in mind;
• bleeding due to cervical dilatation. At the onset of labour, this is known as a show;
• fetal bleeding – this will come from blood vessels between the fetus and placenta (vasa praevia).
