Underlying

A 30 year old woman presents with spontaneous painless vaginal bleeding at 32 weeks of her third pregnancy.

She experienced vaginal spotting about a month ago, after she had engaged in sexual intercourse.

Her medical history is unremarkable, while her two previous pregnancies were uncomplicated, ending with vaginal deliveries at term.

Choisissez les Examens Pertinents
Transvaginal Ultrasound

Faits

The ultrasound scan shows an anterior placenta in the lower uterine segment, with its inferior edge partially overlapping the internal cervical os.
Cardiotocography

Faits

Cardiotocography shows a baseline fetal heart rate of 150 bpm with normal variability and periodic accelerations. There are no decelerations; nor is there evidence of uterine contractions.
Grouping & Crossmatching

Faits

Her blood group is O negative.
Two pints of blood are crossmatched and reserved.
MRI Abdomen

Faits

You realize that the resultant delay might not be a good idea in a patient with recent bleeding.

Choisissez les Prises en Charge Pertinentes
Transfuse Blood
Urgent Cesarean Section
Anti-D Immunoglobulin
IM Corticosteroids