Vaginal Bleeding in Late Pregnancy.

Affiliation

Department of Emergency Medicine, Virginia Tech Carilion School of Medicine, Carilion Medical Center, 1 Riverside Circle, 4th Floor Admin, Roanoke, VA 24016, USA. Electronic address: [Email]

Abstract

Bleeding in late-term pregnancy can present as an innocuous start to parturition or a catastrophic maternal-fetal hemorrhage masked by the physiologic adaptations of pregnancy. The emergency management of late-term bleeding can be challenging, especially when providing stabilizing care in a limited-resource environment. Early recognition of life-threatening vaginal bleeding, potential causes, and emergency management of maternal-fetal distress is reviewed. Maternal resuscitation with balanced versus targeted blood products replacement is presented for low-resource versus high-resource environments. Emergency department readiness for such a patient, in combination with appropriate consultation or transfer, is essential to the effective management of late-term vaginal bleeding.

Keywords

Abruption,Antepartum,Bleeding,Disseminated intravascular coagulopathy,Hemorrhage,Placenta previa,Pregnancy,Thromboelastography,

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