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Fill it, reclose the bag, and transfuse the patient. If infection is suspected (for example, in cases of uterine rupture), autotransfusion is absolutely contraindicated. 32 2. Bleeding during pregnancy Molar pregnancy (hydatidiform mole) Pathological pregnancy due to cystic degeneration of the placenta, common in Asia and North Africa. The mole presents in the form of translucent vesicles, 1 to 2 cm in diameter, connected by filaments like a cluster of grapes. In most cases there is neither foetus nor amniotic sac (Figure 12).

31 2 Bleeding during the first half of pregnancy Figure 11 Intraperitoneal injection of Ringer Lactate – Collect the effluent, letting it drain by gravity back into the bag: • If the effluent is clear, there is no haemoperitoneum: remove the trocar, close the skin and monitor the patient. • If the effluent comes back pinkish, despite changes in the position of the trocar and the patient, disconnect the infusion, secure the trocar to the skin, and cover it with a sterile dressing. Repeat the lavage as needed, depending on changes in the patient's clinical condition under supervision.

During pregnancy, the cervix can present an extremely worrying appearance. Do not be overalarmed, or hastily conclude that it is cancer. If in doubt, see the patient again 3 months after delivery to re-examine the cervix. Functional bleeding in early pregnancy This is a diagnosis of exclusion. 1. Diagnosis – Light bleeding. – Normal size uterus; long, closed posterior cervix; no adnexal mass. 2. Management Rest; no medication indicated. 34 2. Bleeding during pregnancy Bleeding during the second half of pregnancy There are three conditions that can quickly become life-threatening to both mother and child: placenta praevia, abruptio placentae, and uterine rupture.

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