Vaginal bleeding in late trimester constitutes some of the life-threatening complications for mother and neonate. Early recognition and effective management of the conditions—placenta previa, abruption placentae, and vasa previa—may reduce the maternal and perinatal mortality. Placenta previa is usually diagnosed before 20 weeks, but 90% resolves before 28 weeks. Persistent placenta previa in the third trimester mandates pelvic rest and hospitalization, if significant bleeding occurs. Placental abruption may require urgent termination of pregnancy to prevent maternal and fetal morbidity. Vasa previa is also a rare condition requiring urgent cesarean section to prevent fetal mortality. Significant vaginal bleeding from any cause is managed with rapid assessment of maternal and fetal status, fluid resuscitation, replacement of blood and blood products whenever necessary, and an appropriately timed delivery.
KeywordsVaginal bleeding Placenta previa Abruption placentae Vasa previa Maternal mortality
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