28-year-old G3P2 woman at 35 weeks’ gestation presents with painful uterine contractions with dark, altered vaginal bleeding. On examination, uterus is tender, BP is 160/100, PR 100/min, and P/V shows altered blood, with 2 cm vaginal dilatation. Which of the following describes the most likely etiology of her bleeding?
Correct Answer: Placenta abruption
Description: This is a case of Pre eclampsia complicated by abruption as her BP is high, uterus is tender and altered blood is seen per vaginum Placenta pre and vasa pre usually present with painless bleeding. Show is cervical mucous plug that is released prior to or at the time of onset of labour. It is mucoid in consistency and is usually blood mixed. It is a normal finding in labour. PAGE's classification of abruption Class 0: Asymptomatic. Diagnosis made retrospectively by finding organized blood clot or depressed area on a delivered placenta. Class 1: Mild ( 48%) Bleed seen only after delivery no uterine tenderness Fetus is alive and FHR is normal Class 2: Moderate (27%) Bleed seen during labour associated with uterine tetany Fetal hea rate - Normal Class 3: severe (24%) Most severe FHR problem, distress present A- without DIC B - with DIC
Category:
Gynaecology & Obstetrics
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