Massive or recurrent antepartum haemorrhage

Haemorrhage complicates approximately 3% of pregnancies. Of these, about one-third are caused by placenta praevia, one-third by placental abruption and the remainder by other causes. Both placenta praevia and abruption can cause sudden unexpected and significant haemorrhage. They are potentially dangerous to both mother and fetus. Both require resuscitation of the mother and possibly delivery of the fetus. Complications such as disseminated intravascular coagulation and postpartum haemorrhage may occur.

Numerous reports have emphasised the need for all obstetric units to have in place plans for the management of massive obstetric haemorrhage and for all units to practise these protocols regularly.