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Complication of pregnancy

Author: RxPG, Posted on Friday, September 24 @ 00:00:00 IST by RxPG  

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Obstetrics

A hypertensive pregnant woman at 34 weeks comes with history of pain in abdomen, bleeding per vaginum and loss of fetal movements. On examination the uterus is contracted with increased uterine tone. Fetal heart sounds are absent. The most likely diagosis is:
 
1. Placenta praevia.
2. Hydramnios.
3. Premature labour.
4. Abruptio placenta.
 


Answer
4. Abruptio placenta.

Reference placenta
Test book of Obstetrics 4th Edition D.C.Dutta Page 268
Mudaliar Ninth Edition Page 237

Quality
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Status
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Discussion
Abruptio Placenta is also called as
·         Accidental haemorrhage
·         Ablatio Palcenta
·         Premature Seperation of Placenta
Look at the features
·         Pain Abdomen
·         Bleeding per vaginum
·         Loss of fetal movements.
·         Uterus is contracted with
·         Increased uterine tone.
·         Fetal heart sounds are absent.

Explanation
1. Placenta praevia is painless bleeding PV.
2. Hydramnios is not associated with Bleeding PV.
3. Premature labour may not have absent FH .
4. Abruptio placenta is the ideal choice.

Comments
The differences between Placenta Praevia and Accidental Haemorrhage are given in all books and to repeat it once again in this “small” book is going to serve no further purpose

Tips
Note that presence of Couvelaire Uterus per se in Not an indication for Hysterectomy


 

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