drdg
Forum Senior
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Posts: 176
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a 25-year-old woman G1P0 at 28 week's gestation is brought to the ER due to acute onset of severe uterine contractions and moderate vaginal bleeding. She is being followed for chronic hypertention, secondary to a chronic renal problem. Ultrasonogram in the ER shows mild abruption with a small retroplacental hematoma, and an intrauterine gestation consistent with dates; no placenta previa is noted. T:37C, BP:140/86 mmHg, Pulse 76 and PP: 17. Physical exam shows uterine tenderness, increased uterine tone, and mild vaginal bleeding. Cervix is 2 cm dilated and 50 % effaced, the membrane are intact. Fetal heart tracing shows 140/min and long-term variability of 6 cycles/min; beat-to-beat variability is 2/min. After initial rescitation bleeding has stoped. Ultrasonogram was performed a second time, and the hematoma seems to have increased in size. Which of the following is the most approptiate next step in management?
A. Tocolysis with ritodrine
B. Administeration of fresh frozen plasma
C. Order bed rest and perform cervical cerclage
D. Emergency C. section
E. Augmentation of labor and vaginal delivery
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| hanialkhadher
Forum Elite
Topics: 18
Posts: 262
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bring that baby out
E. Augmentation of labor and vaginal delivery
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"أقرأ بأسم ربك الذي خلق,خلق الأنسان من علق,أقرأ و ربك الأكرم, الذي علم بالقلم,علم الأنسان ما لم يعلم"
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| titly
Forum Elite
Topics: 22
Posts: 326
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augmentation of labour n vaginal delivery.
i think administering FFP is also essential.
wat do u think?
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| drdg
Forum Senior
Topics: 31
Posts: 176
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Yes, the correct is E.
Take the boby out. Augmentation of labor and vaginal delivery is right choice, there is no C. Section indication.
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| MAGY17
Forum Elite
Topics: 30
Posts: 234
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agree
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