differential diagnosis of third trimester bleeding
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Differential Diagnosis of Third Trimester Bleeding1. Blood Show2. A Bruntio placenta3. Placenta previa4. Visa previa5. Uterine rupture6. Cervical pathology
- Polyps- Carcinoma- varicositis
7. Maternal coagulopathy- Pre eclampsia- Intra uterine demise- other causes of coagulopathy
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Placenta Previa Versus Abruptio Placentae
Placenta Previa Abruptio Placenta
Pain Painless Bleeding Pain Fula Bleeding
Blood Bright Red Portwne
Clotting Yes No
Blood loss Obvious Conceales behind the placenta
DIC Rare Possioility
Diagnosis Confirmed by Ultrasound Clinical and ultrasound
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Diagnosis of Dessminated Intravascular coagulopathy
• Clinical Suspicions- Pregnancy- Non-Clotting Blood- In ability to control hemorrhage
• Laboratory- Prolonged PT / PTT- Low Fibrinogen level- low platelet count- Presence of fibrin degradation products
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Coagulation Changes of Pregnancy• Increased factor level
- Fibrinogen- Faktor V,VII, VII, IX, X, XII- Fibrin split products Von Willebrand Factor
• No change- Factor XI- Antithrombin III- Platelet count
• Decrease- Factor XIII- Platelet count- PT- PTT