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Maternal death – antepartum hemorrhage – non-obstetric causes: Cervicitis

Antepartum hemorrhage, the condition of bleeding from or in towards the vaginal tract, can complicate pregnancies for mothers.

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There are several different causes including antepartum hemorrhage, including polyps, vaginal cancer, and cervicitis. Regardless of the cause, a doctor should be prepared to identify these concerns and monitor the condition closely. When physicians do not diagnose these concerns and implement efforts to stop the bleeding, APH can lead to maternal injuries or possibly death. If not caught quickly, the baby’s health may also be at risk.

Research published by the National Institutes of Health shows that half of the cases of APH presented to physicians are ultimately diagnosed with placenta previa or placental abruption, whereas no clear or final diagnosis is made in the remaining half of cases. The difficulty in determining the cause of APH means that some of these cases are never fully diagnosed and the mother does not get the immediate help needed to address the symptoms.

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What is Cervicitis?

Cervicitis is a condition involving inflamed or swollen tissue near the uterus. This is most frequently caused by an infection caught due to sexual activity.

Sexually transmitted infections or STIs that may ultimately cause cervicitis include:

  • Trichomoniasis
  • HPV
  • Herpes virus
  • Gonorrhea
  • Chlamydia

There are several other risk factors that can ultimately cause cervicitis including:

  • Exposure to a chemical
  • Allergy to spermicides used for birth control
  • Devices inserted into the patient’s pelvic area like a diaphragm or cervical cap
  • A latex condom allergy

Cervicitis Symptoms

The symptoms of cervicitis include:

  • Abnormal vaginal bleeding that occurs following menopause, after intercourse or between periods
  • Pain in the vagina
  • Uncomfortable sexual intercourse
  • Heaviness or pressure in the pelvis
  • Unusual vaginal discharge

A pelvic exam is typically accomplished to look for redness of the cervix, discharge from the cervix, or inflammation near the vagina walls. Cervicitis can also increase a patient's chances of antepartum hemorrhage.

Evaluation with a sterile speculum can be performed safely before an evaluation of the placental location. However, this typically should not be carried out unless ultrasonography excludes placenta previa. The initial management of any significant bleeding late in the pregnancy process should be monitored by a physician immediately after it occurs. Identifying the options for protecting a mother as well as the child to manage PPH effectively can help to save both and maintain their health. However, a doctor's failure to act promptly and effectively could lead to serious injuries or even maternal death.