Woman at 34 weeksโ gestation with abdominal pain and vaginal bleeding (which should sound off alarm bells for placental abruption), most consistent with placental abruption
Anterior placenta and abdominal pain are inconsistent with placenta previa
Preeclampsia can lead to abruptio placenta, and that may be the case here
Risk factors for placental abruption: Maternal hypertension/pre-eclampsia/eclampsia, abdominal trauma, prior placental abruption, drug use (cocaine, tobacco)
Management of placental abruption: Aggressive maternal fluid resuscitation with crystalloids + delivery
The apparent lack of fetal distress threw me off here. I figured there was some uterine vaso-occlusive issue and went with sickle cell crisis (which would be the first I've heard of this, so, stupid choice by me).
wutuwantbruvThat was my initial thought process as well but then I decided common things are common. Definitely not a fan of this NBME. Poor questions that make me think about completely extraneous things.+1
jlbaeThis threw me off too, but apparently only 60% of cases of AP cause fetal distress+3
submitted by โstep_prep5(246)
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