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Obstetrical hemorrhage : ウィキペディア英語版
Obstetrical hemorrhage

Obstetrical hemorrhage refers to heavy bleeding during pregnancy, labor, or the puerperium. Bleeding may be vaginal and external, or, less commonly but more dangerously, internal, into the abdominal cavity. Typically bleeding is related to the pregnancy itself, but some forms of bleeding are caused by other events.
Obstetrical hemorrhage is a major cause of maternal mortality.
==Early pregnancy bleeding==
In ICD-10, early pregnancy bleeding (code O20.9) refers to obstetrical hemorrhage before 20 completed weeks of gestational age.〔(page 436 ) in: 2013 ICD-10-CM Draft Edition, by Carol J. Buck, Elsevier Health Sciences, 2013. ISBN 9781455774883.〕〔(2014 ICD-10-CM Diagnosis Code O20.9 ) from 2014 ICD-10-CM/PCS Medical Coding Reference].〕
First trimester bleeding, is obstetrical hemorrhage in the first trimester (0 weeks-12 weeks of gestational age). First trimester bleeding is a common occurrence and estimated to occur in approximately 25% of all (clinically recognized) pregnancies.〔Pregnancy, Bleeding. eMedicineHealth. URL: (http://www.emedicinehealth.com/pregnancy_bleeding/article_em.htm ). Accessed on: April 12, 2009.〕
Differential diagnosis of first trimester bleeding is as follows, with the mnemonic AGE IS Low (during first trimester):
*Abortion (spontaneous), that is, miscarriage. One study came to the result that the risk of miscarriage during the course of the pregnancy with just spotting during the first trimester was 9%, and with light bleeding 12%, compared to 12% in pregnancies without any first trimester bleeding. However, heavy first trimester bleeding was estimated to have a miscarriage risk of 24%.
*Gestational trophoblastic neoplasia
*Ectopic pregnancy, which implies a pregnancy outside the uterus, commonly in the tube, and may lead to bleeding, internally, that could be fatal if untreated. In cases where there is a heavy bleeding and an obstetric ultrasonography comes to the result of pregnancy of unknown location (no visible intrauterine pregnancy), is has been estimated that approximately 6% have an underlying ectopic pregnancy.
*Implantation bleeding
*Chorionic hematoma
*Spotting
*Lower GU tract causes
*
*Vaginal bleed
*
*Cervical bleed

抄文引用元・出典: フリー百科事典『 ウィキペディア(Wikipedia)
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