A basic presentation about bleeding in pregnancy for non-medical people. Includes links to organisations that work towards reducing maternal mortality world-wide.

1. An introduction for non-medical audiences
Dr Max Mongelli
Nepean Clinical School
University of Sydney

2. Bleeding during pregnancy is common
• May affect up to 20% of all pregnancy
• Can occur in any trimester, during and after delivery
• Often difficult to predict
• In most cases in not severe
• Usually treatable

3. • Also known as a threatened miscarriage
• However most women will not miscarry
• May be due to bleeding from the placenta
• Or could be due to local causes such as lesions on the cervix or in
the vagina

4. • Same causes as in the first trimester
• Requires medical assessment and ultrasound

5. • From about 24 weeks onwards
• Could be due to an abnormally low placenta - known as
“placenta previa”
• Sometimes caused by separation of the placenta from
the uterus – “placental abruption”
• If significant, admission to hospital is required
• If heavy, may lead to preterm delivery. An emergency
cesarean section may be indicated
• Often, no cause can be found

6. • Also known as “intrapartum bleeding”
• Usually minor
• Requires close monitoring
• If heavy, urgent delivery is needed

7. • Known as post-partum hemorrhage
• Up to 500 ml of blood may be normal
• Most common cause is a floppy uterus - “uterine atony”
• Most cases (90%) can be treated with medications
• Some cases require surgery
• Very heavy bleeding can be life-threatening

8. • Most deaths from bleeding occur in developing countries
• Due to poor access to medical facilities
• Poor antenatal care
• Geographical barriers to reach hospitals
• Inadequate medical facilities
• Lack of blood for transfusions

9. Support :
• Project Hope: www.projecthope.org
• UNICEF: www.unicef.org
• CARE: www.care.org