PTM essay

Severe obstetric haemorrhage is the leading cause of maternal death worldwide, with an average of five/1000 mothers being affected (Al-Zarqi, Vangen, Forsen, & Stray-Pedersen, 2008). Obstetric haemorrhage includes postpartum and antepartum bleeding, where if not managed correctly, can lead to mortality. For this reason, it is important for health practitioners to have an in depth understanding of the epidemiology, assessment, presentation and pre-hospital management principles associated with both antepartum and postpartum haemorrhage. Furthermore, the cultural and ethical considerations involved with the birthing and treatment regime of obstetric complications are also an important aspect to understand in order to avoid insult and detrimental relations from evolving.

Antepartum haemorrhage

Antepartum haemorrhage (APH) is described as bleeding from the genital tract after 20 weeks gestation, and is commonly caused by placental abruption, uterine rupture and placental praevia (Giordano, Cacciatore, Cignini, Vigna & Romano, 2010).

Placental abruption occurs when a normally situated placenta (or part of) prematurely separates from the uterine wall, resulting in an APH (Ngeh & Bhide, 2006). Although, the exact cause of placental abruption is debatable, it has been found to occur in approximately one in 80 births (Ngeh & Bhide, 2006), with 78% of those resulting in antepartum haemorrhage (Chang, Chang, & Cheng, 2001). Bhide (2008), states that pre-pregnancy factors such as: previous caesarean section (C-section) and uterine malformations can increase the risk of placental abruption. Wilde (2005) concurs with this statement, and goes on to explain that woman who participate in smoking or drinking whilst pregnant or have pre-eclamps...

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...cience refers to the act of not harming, or providing an ineffective treatment or will do more harm than good. An emergency C-section is an example where beneficence and nonmaleficience are both considered as the procedure may do some harm, but will provide a better outcome for both baby and mother. Autonomy is the term used to describe a patient’s right to make their own decisions and give consent about which treatment they are to receive. Justice dictates that everyone should be treated equally based on their needs, rather than their ethnicity, age, sex or religion.

All healthcare professionals should have a vast understanding of patient rights, ethics and cultural considerations as this will not only benefit the patient in terms of receiving the best treatment regime available, but will also improve the overall perception of healthcare in the general public.