CASE #4 : BLEEDING IN LATE PREGNANCY ( Abruptio Placenta) Setting: Hospital Chief Complaint: Vaginal Bleeding History Present Illness: A nulliparous woman who has presented with vaginal bleeding at 39 weeks, 5 days gestation. Booking BP = 123/72mmHg. Her last midwife visit was 10 days ago when BP = 130/76mHg. This evening she noticed a small gush of blood and discovered a bright red stain in her underclothes. She denies actual abdominal pain but reports some intermittent lower abdominal discomfort. The baby has been moving normally during the day. Physical Examination: She is warm and well perfused. Her BP = 158/87mmHg and Pulse Rate = 84bpm. The symphysiofundal height is 36cm and the fetus is cephalic with 3/5 palpable abdominally. Moderate uterine tenderness is noted. The uterus is soft but during the palpation two moderate uterine tightenings are noted. On speculum examination the cervical os is closed and there is a moderate amount of vaginal blood. LABORATORY Urinalysis Result Protein- + Blood- ++ Leucocytes- Negative Nitrites- Negative Question: Make a pathophysiology about this case. Explain each disease process. Include the signs and symptoms of this case and the modifiable and non modifiable factors. (Please show in a diagram)
CASE #4 : BLEEDING IN LATE PREGNANCY ( Abruptio Placenta) Setting: Hospital Chief Complaint: Vaginal Bleeding History Present Illness: A nulliparous woman who has presented with vaginal bleeding at 39 weeks, 5 days gestation. Booking BP = 123/72mmHg. Her last midwife visit was 10 days ago when BP = 130/76mHg. This evening she noticed a small gush of blood and discovered a bright red stain in her underclothes. She denies actual abdominal pain but reports some intermittent lower abdominal discomfort. The baby has been moving normally during the day. Physical Examination: She is warm and well perfused. Her BP = 158/87mmHg and Pulse Rate = 84bpm. The symphysiofundal height is 36cm and the fetus is cephalic with 3/5 palpable abdominally. Moderate uterine tenderness is noted. The uterus is soft but during the palpation two moderate uterine tightenings are noted. On speculum examination the cervical os is closed and there is a moderate amount of vaginal blood. LABORATORY Urinalysis Result Protein- + Blood- ++ Leucocytes- Negative Nitrites- Negative Question: Make a pathophysiology about this case. Explain each disease process. Include the signs and symptoms of this case and the modifiable and non modifiable factors. (Please show in a diagram)
Chapter13: Nerves Of Steel
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CASE #4 : BLEEDING IN LATE PREGNANCY ( Abruptio Placenta)
Setting: Hospital
Chief Complaint: Vaginal Bleeding
History Present Illness: A nulliparous woman who has presented with vaginal bleeding at 39 weeks, 5 days gestation. Booking BP = 123/72mmHg. Her last midwife visit was 10 days ago when BP = 130/76mHg.
This evening she noticed a small gush of blood and discovered a bright red stain in her underclothes. She denies actual abdominal pain but reports some intermittent lower abdominal discomfort. The baby has been moving normally during the day.
Physical Examination:
She is warm and well perfused. Her BP = 158/87mmHg and Pulse Rate = 84bpm. The symphysiofundal height is 36cm and the fetus is cephalic with 3/5 palpable abdominally. Moderate uterine tenderness is noted. The uterus is soft but during the palpation two moderate uterine tightenings are noted. On speculum examination the cervical os is closed and there is a moderate amount of vaginal blood.
LABORATORY
Urinalysis
Result
Protein- +
Blood- ++
Leucocytes- Negative
Nitrites- Negative
Question:
Make a pathophysiology about this case. Explain each disease process. Include the signs and symptoms of this case and the modifiable and non modifiable factors. (Please show in a diagram)
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