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Case Review : Antepartum Hemorrhage


A 19 years female primi at 29 weeks period of gestation complained of heavy per vaginal bleeding for 3 hrs,clots were passed. However she did not  have lower abdominal pain. She had perceived good fetal movement. Her Antenatal check up was done at health post, she took Iron tablets regularly and had taken 2 doses of Tetanus Toxoid inj.

She had normal menstrual cycle, no use of any contraceptive measures.her past,family and personal history are not significant.

On Examination:

General Condition-fair     Pallor Icterus Edema-nil       vitals– stable

per abdomen: uterus 24 weeks size , mild contraction +

per vaginum: no active bleeding, clots removed from vagina,os closed,cervix- ballooned up in upper part

Diagnosis- primi at 29 weeks Period Of Gestation with Antepartum Hemorrhage


Hb%- low

USG report– 26-27 weeks single live intrauterine pregnancy,breech,posterior placenta,oligohydraminos,fetal hydracephalus and deformed fetus




Induction of labour with misoprostol 200micro gm per vaginum

Blood transfusion-

IV antibiotics

Monitoring of vitals and input output

After few hours, patient was shifted to ot for lscs as placenta was felt on p/v examination, diagnosis being central placenta previa

She was totaly transfused 4 units of whole blood to restore her haemoglobin


Image: Grossly malformed fetus

Image: Grossly malformed fetus

picture showing congenitally malformed fetus

picture showing congenitally malformed fetus with hydrocephalus, gastroschisis,deformed limbs attached to the neck of fetus


Case Collected and Worked Out By: Dr. Anjali Subedi

Tags: Antepartum, APH, Congenital malformation, Hemorrhage, Placenta Previa

Last updated: October 14, 2013

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This entry was posted by on October 15, 2013 at 1:50 pm and filed under Medical Cases category.

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