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Gynaecology & Obstetrics General 4118ea17

A 29-year-old G3P2 woman at 34 weeks' gestation is involved in a serious car accident in which she lost consciousness briefly. In the emergency department she is awake and alert and complains of a severe headache and intense abdominal and pelvic pain. Her blood pressure is 150/90 mm Hg, heart rate is 120/min, temperature is 37.4°C (99.3°F), and respiratory rate is 22/min. Fetal heart rate is 155/min. Physical examination reveals several minor bruises on her abdomen and limbs, and vaginal inspection reveals blood in the vault. Strong, frequent uterine contractions are palpable. Which of the following is most likely a complication of this pts present condition:

A
DIC
B
IUGR
C
Subarachnoid hemorrhage
D
Vasa previa
High-Yield Explanation
In the question patient at 34 weeks of gestation is involved in a car accident. (Note: trauma is a risk factor for APH). Her BP is 150/90 mm (High BP is a Risk factor for abruptio). On vaginal inspection - bleeding is present along with strong uterine contractions so the diagnosis of abruptio confirmed. DIC due to release of thromboplastin by damaged placenta is a well known complication of abruptio.

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