Match each clinical presentation of peripartum complications to the most accurate diagnostic etiology.
- A G2P1 patient at 37 weeks of pregnancy presents with sudden-onset, severe, continuous abdominal pain and dark vaginal bleeding. Examination reveals a rigid, hypertonic uterus.Placental abruption
- An otherwise healthy G3P2 patient at 36 weeks of pregnancy reports a sudden episode of painless, bright red vaginal bleeding. Her abdomen is soft and non-tender.Placenta previa
- A G4P3 patient at 39 weeks of pregnancy with a history of a prior classical cesarean delivery experiences sudden tearing abdominal pain, followed by an immediate upward shift in fetal station.Uterine rupture
- A G1P0 patient at 38 weeks of pregnancy undergoes artificial rupture of membranes, which is immediately followed by a gush of blood-tinged vaginal fluid and acute, sustained fetal bradycardia.Vasa previa
- A G1P0 patient at 39 weeks of pregnancy experiences sudden, profound cardiovascular collapse and hypoxemic respiratory failure immediately following a prolonged vaginal delivery.Amniotic fluid embolism
Answer
1 matches with Placental abruption, 2 matches with Placenta previa, 3 matches with Uterine rupture, 4 matches with Vasa previa, and 5 matches with Amniotic fluid embolism.
Each clinical vignette provides classic pathognomonic signs for distinct obstetric emergencies. Painful bleeding with a firm uterus indicates placental abruption. Painless bleeding with a soft uterus indicates placenta previa. Sudden loss of fetal station with a prior classical incision indicates uterine rupture. Bleeding and fetal bradycardia post-amniotomy indicate vasa previa. Immediate postpartum cardiovascular collapse indicates an amniotic fluid embolism.
Step-by-Step Solution
Key Concept
Clinical differentiation of severe obstetric complications based on pain, timing of bleeding, fetal heart rate changes, and maternal vital signs.