Question

A 24-year-old G1P0 African American woman arrives by ambulance. The EMTs report that her initial BP was 180/100 (high normal for someone in pain and she was hypertensive)and her pulse was 110. They estimate she lost at least 500 mL blood in transit. Her husband is right behind and reports that she is 36 weeks by LMP. Her only complications in prenatal care was hypertension that did worsen over time a bit, but did not worry the doctor too much. The husband reports that the 12-week ultrasound was "fine". They came to town for a family member's birthday and her care provider is in another state (and this is a weekend). At the party, she complained of intense abdominal pain and began to hemorrhage. The vaginal bleeding is profuse and the patient is unstable and unable to communicate coherently. Her BP at first vitals check is 90/50 (low normal but falling rapidly) and her pulse rate is 120 (high). She appears to be in significant pain the abdomen is quite rigid. What are the most 2 likely diagnoses with what you know now?

• E. uterine inversion and uterine rupture
• D. placental abruption grade 3 and uterine rupture
• B. placental abruption grade 1 and placental abruption grade 2
• A. placenta previa and placenta accreta
• C. placental abruption grade 2 and placental abruption grade 3
• F. velamentous cord insertion and eclampsia

Answer 1

Answer:

C). Placental abruption grade 2 and placental abruption grade 3.

Reason:

Placental abruption is the Premature separation of placenta from the uterine wall.

*One cause of placental abruption is hypertension

*Signs and symptoms of placental abruption grade 2 are:

.Mild to moderate bleeding

.Uterine contractions

*Signs and symptoms of placental abruption grade 3 are:

.Moderate to severe bleeding

   . Abdominal pain

.Uterine contractions

.Hypotension and tachycardia