O46.012
Antepartum hemorrhage with afibrinogenemia, second trimester
Clinical Classification Guidelines
Medical Intelligence & Overview
Antepartum hemorrhage refers to bleeding from the genital tract occurring after 20 weeks of pregnancy but before the birth of the baby. When this bleeding is combined with afibrinogenemia—a rare blood disorder characterized by the absence or extremely low levels of fibrinogen, a protein essential for blood clotting—it can pose significant health risks for both mother and baby. Specifically, this diagnosis pertains to cases in the second trimester, between 13 and 28 weeks of pregnancy, where bleeding complications are accompanied by this clotting disorder. Recognizing and understanding the condition can help in managing it effectively and in preventing potential complications.
Causes & Symptoms
Clinical Causes: Blood clotting disorders such as afibrinogenemia, which impair the body's ability to form stable clots, leading to bleeding Placental abruption, where the placental lining separates from the uterus prematurely Placenta previa, where the placenta covers the cervical opening Infections or inflammatory conditions affecting the placenta or uterine lining Trauma or injury to the abdomen during pregnancy Coagulopathies associated with other medical conditions
Key Symptoms: Vaginal bleeding or spotting, which can vary in amount Abdominal pain or cramping Back pain or pelvic discomfort Signs of shock in severe cases, such as dizziness, weakness, or fainting Rapid heart rate Signs of anemia, including fatigue or pallor
Diagnostic & Treatment
Diagnosis Path: Pelvic examination to determine the source and amount of bleeding Ultrasound imaging to assess placental location and placental health Blood tests to evaluate coagulation parameters, including fibrinogen levels, complete blood count (CBC), and clotting times Additional tests to identify underlying causes such as infections or placental abnormalities
Treatment Protocols: Blood product transfusions, such as fibrinogen concentrates or cryoprecipitate, to restore fibrinogen levels Close monitoring of maternal vital signs and fetal status Hospitalization for intensive observation and management during acute episodes Medications to promote clot formation if appropriate Delivery planning, often via early delivery if fetal or maternal health is threatened Addressing underlying causes or co-existing conditions that may aggravate the bleeding
Clinical Advice & FAQs
Billing Guidance
Is O46.012 a billable ICD-10 code?
Yes, O46.012 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.
Documentation
How do I report O46.012?
Clinical documentation must specify the nature of Antepartum hemorrhage with afibrinogenemia, second trimester and any associated comorbidities for accurate reporting.
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