European Journal of Molecular & Clinical Medicine

Abstract

Antepartum hemorrhage (APH) is defined as bleeding from or into the genital tract
during pregnancy after the period of viability until delivery of fetus¹. The World Health
Authority defines antepartum hemorrhage as bleeding after 28th week of pregnancy. On
an average 2 to 5% of all pregnancies are complicated by antepartum hemorrhage.
Antepartum hemorrhage accounts for about 22-25% of maternal mortality¹.
Causes of antepartum hemorrhage include placenta previa (PP) and placental abruption (AP).
vasa previa, marginal vein bleeding, trauma due to foreign body or genital lacerations and cervical polyp, cervical carcinoma, local lesions of vagina and cervix and systemic diseases like leukemia & bleeding disorders
In Placenta previa, placenta is implanted wholly or partly into the lower
segment of the uterus whereas an abruption of placenta is the condition where bleeding occurs
due to premature separation of a normally sited placenta². 
The incidence of placenta previa (PP) is about 0.33% to 0.55% and incidence of abruptio placenta (AP) is about 0.5-1%¹.
Presently increase in use of ultrasound for prompt diagnosis, with improved obstetrical and anesthetic facilities, increase in use of blood and blood products and advanced neonatal care facilities have played an important role in decreasing perinatal as well as maternal morbidity and mortality in antepartum hemorrhage. 
APH causes increase in maternal complications like malpresentations, higher rates of caesarean section, premature labor, postpartum hemorrhage, increased need for peripartum hysterectomy, puerperal infections, sepsis,shock, coagulation failure and retained placenta and fetal complications due to APH include prematurity, low birth weight, congenital malformations, birth asphyxia and intrauterine death.  All these contribute to increased maternal morbidity and mortality rates