Antepartum hemorrhage is bleeding that occurs in the birth canal or vagina when pregnancy enters the age of 24 weeks until just before the baby is born into the world. If bleeding occurs after labor is completed, then the condition is called postpartum hemorrhage.
Bleeding that occurs in the second and third trimesters of pregnancy can cause a variety of dangerous complications, both for mothers and babies. But if treatment is done immediately, then the risk of complications can decrease.
Causes of antepartum hemorrhage
Bleeding that occurs after 24 weeks of gestation, is not always dangerous. However, if the volume of blood that comes out quite a lot and is accompanied by pain or other health problems, then there is a possibility that your pregnancy is being disrupted.
There are several conditions that cause antepartum hemorrhage to occur, namely placental abruption, placenta previa, and vasa previa.
1. Placental abruption
Placental abruption or placental abruption is a condition of the detachment of the placenta from the uterus. There are several things that are believed to trigger this condition, namely the lack of blood supply to the placenta and a violent impact due to an accident.
Bleeding that occurs due to this condition is usually quite a lot of volume, but not very visible. Because, many pools of blood are trapped behind the placenta.
There are several factors that place a person at higher risk for placental abruption, including:
- History of hypertension
- Age over 35 years
- Smoking habits during pregnancy
- Cocaine abuse during pregnancy
- Has had a placental abruption in a previous pregnancy
2. Placenta previa
A pregnant woman is said to have placenta previa if the placental position covers the cervix or cervix which is the birth canal. This condition can cause vaginal bleeding, although it often occurs without pain.
In some cases, the position of the placenta can shift by itself when the womb enters 32-35 weeks. Because at that gestational age, the lower uterus has begun to enlarge and thin out so that the placenta no longer covers the cervix.
When placenta previa can be resolved, labor can be done in a normal manner. Conversely, if the placenta is still covering the cervix which is the birth canal, then labor needs to be done before the estimated day of birth (HPL) by Caesarean section.
Risk factors for placenta previa are not much different from placental abruption. One thing that distinguishes is that in placenta previa, a history of curettage can increase the risk of this condition.
3. Vasa Previa
In the umbilical cord there are blood vessels that function to provide food for the fetus. In people who experience vasa previa, the blood vessels grow excessively, covering the cervix and birth canal.
When labor arrives, the blood vessels that cover the birth canal can rupture, and make the fetus lack of blood supply. If not treated immediately, this condition can cause infant death.
Some factors that increase the risk of vasa previa include:
- Pregnancy through IVF or IVF methods
- The occurrence of placenta previa in the second trimester of pregnancy
- Low placental position
- Twins pregnancy
Impact of antepartum hemorrhage on mother and baby
Antepartum hemorrhage can cause various complications both for mother and baby. In mothers, some of the effects of antepartum bleeding that can occur include:
- Must undergo preterm labor
- The formation of clots in blood vessels
- Acute kidney damage
- Postpartum hemorrhage
- Placenta accreta or placenta that grows too deep into the uterus
- Psychological disorder
Meanwhile for babies, complications that occur include:
- Fetal hypoxia or lack of oxygen supply
- Fetal growth is stunted
- Premature birth