Name of the Condition

• Antepartum Hemorrhage, Unspecified, Third Trimester
• Also known as third-trimester bleeding.

Summary

Antepartum hemorrhage refers to bleeding from the genital tract after the 28th week of pregnancy and before the birth of the baby. The term "unspecified" indicates that the exact cause of the bleeding hasn't been determined.

Causes

• Placental abruption (separation of the placenta from the uterus)
• Placenta previa (placenta covers the cervix)
• Uterine rupture
• Trauma or injury to the abdomen
• Unknown causes (in the case of unspecified diagnosis)

Risk Factors

• Previous history of antepartum hemorrhage
• Multiple pregnancies (twins, triplets, etc.)
• Advanced maternal age
• High blood pressure or preeclampsia
• Smoking or substance abuse during pregnancy

Symptoms

• Vaginal bleeding (can vary from spotting to heavy bleeding)
• Abdominal pain or cramping
• Back pain
• Rapid contractions

Diagnosis

• Physical examination to assess the bleeding
• Ultrasound to determine placental placement and check for any abnormalities
• Blood tests to evaluate mother’s hemoglobin level and blood group

Treatment Options

• Hospitalization for monitoring and more intensive care
• Blood transfusions in case of significant blood loss
• Corticosteroids if the baby is premature to help mature the lungs
• C-section if the bleeding endangers the mother or child

Prognosis and Follow-Up

• With proper treatment, outcomes can be positive, although the risk to mother and child exists with significant bleeding.
• Regular follow-ups are crucial to monitor the progress of pregnancy.

Complications

• Preterm labor or delivery
• Fetal distress or stillbirth
• Maternal hemorrhagic shock
• Increased risk of cesarean delivery

Lifestyle & Prevention

• Avoid smoking and substance use during pregnancy
• Regular prenatal care visits
• Management of blood pressure and other health conditions

When to Seek Professional Help

• Immediate medical attention is necessary if experiencing any vaginal bleeding in the third trimester, especially if accompanied by pain or contractions.

Additional Resources

• American College of Obstetricians and Gynecologists
• March of Dimes
• Local support groups for expectant mothers

Tips for Medical Coders

• Verify the trimester to ensure correct classification under ICD code O46.93.
• Confirm the documentation supports that the cause is unspecified to avoid using more specific codes.