Context

Bleeding in the first trimester is common occurring in up to 30% of pregnancies and being responsible for 50,000 admissions per annum to hospital in the UK [1].

50-80% of patients presenting with first trimester vaginal bleeding will go on to have normal pregnancies. 1/80 pregnancies are ectopic and require prompt diagnosis and management.

Antepartum haemorrhage (APH) has an incidence of 3.5% of all pregnancies. Antenatal screening has reduced maternal mortality from placenta praevia, yet there remains considerable fetal and maternal morbidity and mortality associated with APH [2,3].

10% of births are of Rh-positive babies to Rh-negative mothers. Consideration and appropriate use of anti-D immunoglobulin is highly cost effective and avoids considerable morbidity and mortality [4].

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