A 24yo primigravida who is 30wk pregnant presents to the labor ward with a hx of constant
abdominal pain for the last few hours. She also gives a hx of having lost a cupful of fresh blood
per vagina before the pain started. Abdominal exam: irritable uterus, CTG=reactive. Choose the
single most likely dx?
a. Abruption of placenta 2nd to pre-eclampsia
b. Antepartum hemorrhage
c. Placenta previa
d. Vasa previa
e. Revealed hemorrhage
answer: E
Abruption of placenta is classified as either revealed or hidden. Here bleeding was seen by the patient so it is a Revealed hemorrhage.
Placenta previa is painless bleeding.
No history of hypertension for it to be A
I don't think "E" is the right answer.
ReplyDeleteA= Although c/p is of abruption of placenta but there aren't mention of pre-eclampsia presentation.
B = I think this is the right answer. Any pv bleeding after 24wks of gestation is called Antepartum Haemorrhage. The causes of it are: Placenta praevia, Placental abruption, vasa praevia.
So, option A, C and D come under Antepartum Haemorrhage, and they all present with Revealed Haemorrhage (option E) which is NOT a Dx but a sign.
I agree...B is d key....
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