Case (25)

[Diagnostic]

Safiya is a 37 year old female, G8 P6 who is 35 weeks gestation. Safiya arrives at the hospital with some cramping that began about 25 minutes ago. Membranes are intact. Fetal heart tones and Safiya’s vital signs are stable at the present time. Safiya’s history reveals that she smokes 1 ½ packs of cigarettes daily, had an SAB* at 9 weeks gestation with her last pregnancy. She is blood type A+.

On examination, the abdomen is hard and tender, The fetal monitor is applied externally and reveals uterus that is contracting frequently, but irregularly and fetal heart tones are 168/minute. The uterus never completely relaxes in between each contraction.
Safiya is uncomfortable and anxious, concerned about the well being of her baby.

SAB: Spontaneous Aportion

Questions:
1. What is your diagnosis?
2. What risk factors does Safiya have that are associated with this disease?
3. Which type of this disease would you suspect that Safiya has? Why?
4. What can happen to the uterus and what do you call it?

[Doctoor]

1. What is your diagnosis?
Antepartum hemorrhage (aprubtio placentae)

2. What risk factors does Safiya have that are associated with this disease?
- She is grandmultipra.
- Cigarette smoking
- Previous spontaneous abortion

3. Which type of this disease would you suspect that Safiya has? Why?
- Concealed type of abruption placentae because there is no visible vaginal bleeding.

4. What can happen to the uterus and what do you call it?
Retroplacental blood may penetrate through the thickness of the uterine wall into the peritoneal cavity, a phenomenon known as Couvelaire uterus.
Doctoor

[Diagnostic]

Well done Doctoor,
Your answer is correct.
You deserve the 15 points