Historical context
Edward Rigby produced one of the earliest recorded essays that began to clarify the understanding, clinical presentation, and management of the distinctive causes of APH (8). In his 1775 published work, Rigby gave the first description of premature separation of the normally sited placenta which he termed ‘accidental' haemorrhage in contrast to the ‘unavoidable' haemorrhage of placenta praevia.
His initial case series of 30 ‘accidental' haemorrhages and 14 ‘unavoidable' haemorrhages provided a clear narrative of the impact of APH on maternal and fetal outcome (9). His pioneering essay stimulated further interest and focused work on improving the management and outcome of APH, and two centuries later, the outcome of pregnancies complicated by APH are only marginally better than Rigby's series in many low-resourced countries. This reflection should inform a more decisive commitment to focus on the key drivers for improvement in the quality of care for pregnant women with APH.
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