DOI: 10.36347/sjams.2016.v04i12.049

Pages: 4446-4456

Maternal mortality is a matter of great concern in developed and developing nations. More than 25%of maternal deaths can be attributed to haemorrhage. Availability, of trained birth attendant and emergency medical services are the main objectives for achieving the Millennium Development Goal 2015 of reducing maternal mortality rate to 109/100,000 from the present 190. One of the major shortcomings for providing high quality emergency obstetric care is a serious shortage of specialists such as obstetricians and anaesthetists at various levels in rural setting. Anaesthetists, perhaps the only perioperative physicians in labour room and operating room with special training in resuscitation and critical care get involved early in management of these bleeding patients. The differences in management options between antepartum haemorrhage (APH) and postpartum haemorrhage (PPH) are that there are two individuals to care for in APH and that delivery of the fetus and placenta will help to arrest the bleeding.. The greatest threat in APH is not to the mother but her fetus. Thus a multidisciplinary approach and team effort involving the obstetrician, anaesthetist, haematologist neonatologist, midwifery and paramedic operation theatre staff can go a long way in averting impending death and disability. In this guideline we shall discuss the latest trends in management of APH so that mothers and babies lives and not in jeopardy.