The management of antepartum haemorrhage (excluding placenta praevia).

A 3-year retrospective survey of patients presenting with an antepartum haemorrhage (APH) to The Royal Women's Hospital, Melbourne, was undertaken. Cases of placenta praevia were excluded from the series. The overall perinatal mortality (PNM) was 14.5%. There were 98 patients with accidental haemorrhage (PNM 23.4%) and 101 patients with an APH of unknown aetiology (PNM 6%). Generalized uterine tenderness and tenseness were the most consistent features associated with imminent fetal compromise and it is in this group that an early resort to Caesarean section may be beneficial. The routine use of a clotting profile was found to be of little value, especially in patients with a mild haemorrhage.