Match each clinical presentation of an obstetric emergency to the most likely diagnosis.
- Sudden-onset severe abdominal pain, vaginal bleeding, and frequent late fetal heart rate decelerations at 37 weeks gestation.Placental abruption
- Painless, bright red vaginal bleeding without uterine contractions at 36 weeks gestation.Placenta previa
- Painless vaginal bleeding and profound fetal bradycardia occurring immediately following artificial rupture of membranes.Vasa previa
- Sudden cessation of labor, acute tearing abdominal pain, and loss of fetal station in a patient with a prior cesarean delivery.Uterine rupture
Cevap
Sudden-onset severe pain matches with placental abruption; painless bleeding without contractions matches with placenta previa; bleeding and fetal bradycardia immediately after amniotomy matches with vasa previa; and sudden cessation of labor in a scarred uterus matches with uterine rupture.
Each obstetric emergency has a defining clinical signature. Placental abruption is characterized by painful bleeding and fetal distress. Placenta previa is identified by painless bleeding without contractions. Vasa previa involves painless bleeding of fetal origin immediately upon rupture of membranes, causing rapid fetal bradycardia. Uterine rupture is diagnosed by acute tearing pain, cessation of labor, and loss of fetal station in a patient with a prior uterine scar.
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Anahtar Kavram
Differentiating etiologies of third-trimester bleeding and intrapartum emergencies based on classic clinical features.