Incidences of vasa previa and haemorrhaging in the presence of a succenturiate placenta are highly increased. Fetal blood (can be distinguished with Apt test)

Minor causes
Cervical ectropion
There are 2 types of epithelial cells present within the cervical canal. In the endocervix the epithelia is columnar glandular which transitions into stratified squamous towards the ectocervix and external cervical orifice. During cervical ectropion the epithelial transitional zone (also called the squamo-columnar junction) migrates from the endocervical canal towards the ectocervix exposing some columnar glandular cells on the external cervical orifice. Unlike stratified squamous epithelial cells, glandular cells are columnar and not used to external stresses such as abrasion. The translocation of these cells causes bleeding and mucus secretion. Cervical ectropion can be attributed to rises in oestrogen levels during foetal development. Antepartum haemorrhage caused by cervical ectropion can be expected and is typically harmless.Vaginal infection
The presence of severe vaginal infections at the time of pregnancy may cause minor antepartum haemorrhaging. For example, the presence of chlamydia, thrush, cervicitis or other infections are all irritants to the vaginal and cervical lining, causing bleeding from those surfaces where the infection is severe.Cervical canal and distal genital tract
Most cases of Antepartum haemorrhaging originate from within the cervical canal or vagina. The amount of bleeding in these areas are typically limited to spotting or minor antepartum haemorrhaging. Cervical ectropion, dysplasia, polyps or cervical carcinoma may cause lesions in the cervix leading to minor haemorrhaging or spotting.
Abrasion or slight trauma caused by intercourse, clinical examinations and pap smear may also cause spotting  from the cervix. Vaginal bleeding from atrophy, vaginitis, and ulcers also attribute to minor haemorrhaging. Similarly, varicosities, tumours or inflammation in the vulva can cause minor antepartum haemorrhaging. Non genital tract bleeding caused by haematuria or haemorrhoids can often be mistaken for antepartum haemorrhaging and are typically harmless. Diagnosis
Differential diagnosis
GI bleed - haemorrhoids, inflammatory bowel disease

See also
Obstetrical haemorrhage

References


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