APH(PLACENTAL ABRUPTION)
APH is bleeding from the vaginal tract after period of viability till labour onset. Types are placental causes (placenta previa and abruption) and extra placental causes( vaginal bleeding and cancer) Placenta abruption: it is the premature separation of a normally implanted placenta from the uterus. Pathology of fetal death 1. Uterine vasospasm 2. Venal engulgement 3. Hematoma format...
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Question 1
Multiple choiceA 29-year-old woman at 35 weeks gestation presents with vaginal bleeding and abdominal pain. On examination, her uterus is tender, and she exhibits tachycardia and pallor. What is the most likely diagnosis?
Explanation
The clinical scenario is consistent with placental abruption, characterized by vaginal bleeding, uterine tenderness, and signs of maternal shock.
Question 2
Multiple choiceWhich of the following factors is NOT considered a risk factor for placental abruption?
Explanation
Single gestation without complications is not a risk factor for placental abruption, while the other options are established risk factors.
Question 3
Multiple choiceA pregnant woman at 32 weeks gestation is diagnosed with complete placenta previa. Which delivery method is appropriate if she remains stable?
Explanation
In cases of complete placenta previa, the appropriate method of delivery is an emergency cesarean section to prevent maternal and fetal morbidity.
Question 4
Multiple choiceIn a case of placental abruption, what is the most significant complication that may arise for the mother?
Explanation
Hypovolemic shock is a serious complication that can occur due to significant maternal hemorrhage associated with placental abruption.
Question 5
Multiple choiceA fetal monitoring report shows a decreased fetal heart rate (FHR) while the mother is experiencing uterine contractions. What could be a primary concern in this scenario?
Explanation
Decreased fetal heart rate during contractions may indicate fetal hypoxia, which is an urgent concern requiring immediate evaluation.
Question 6
Multiple choiceIn diagnosing placental abruption, which examination finding is least likely to be observed during a clinical assessment?
Explanation
Bilateral lower limb edema is not a typical finding in placental abruption and is more related to venous congestion or other conditions.
Question 7
Multiple choiceWhen assessing a case of suspected placental abruption, which of the following classifications refers to the nature of bleeding?
Explanation
The classification of revealed vs. concealed refers to the nature of bleeding associated with placental abruption.
Question 8
Multiple choiceA 34-year-old patient presents with severe abdominal pain and vaginal bleeding at 28 weeks gestation. Upon examination, she is in shock. What immediate management should be prioritized?
Explanation
The priority in managing shock is fluid resuscitation and blood transfusion to stabilize the maternal condition before considering delivery.
Question 9
Multiple choiceWhat is the role of ultrasound in managing a case of suspected placenta previa?
Explanation
Ultrasound is critical in confirming the diagnosis and determining the location of the placenta in cases of suspected placenta previa.
Question 10
Multiple choiceIn cases of placental abruption, how is the fetus likely to be affected if immediate intervention is not taken?
Explanation
Without immediate intervention, the fetus is at increased risk of hypoxia and fetal demise due to compromised placental blood flow.
Question 11
Multiple choiceAt what lesion stage in placental abruption is the mother likely to exhibit signs of maternal compromise?
Explanation
In Grade 1 abruption, there can be mild bleeding and slight uterine tenderness, signalling early maternal compromise.
Question 12
Multiple choiceDuring which of the following situations would surgical intervention be prioritised in cases of placental abruption?
Explanation
Surgical intervention is prioritized when the mother is unstable and the fetal heart rate is abnormal, indicating urgent need for delivery.
Question 13
Multiple choiceA patient with a history of recurrent miscarriages presents for an evaluation of her current pregnancy. Which of the following evaluations is essential in understanding her obstetric history related to potential placental complications?
Explanation
Gathering a history of previous placental abnormalities is important to assess risks of complications such as placental abruption or previa.
Question 14
Multiple choiceWhich of the following findings strongly supports a diagnosis of placental abruption rather than placenta previa in a pregnant patient?
Explanation
Severe abdominal pain is more characteristic of placental abruption, while placenta previa typically presents with painless vaginal bleeding.
Question 15
Multiple choiceA 32-year-old pregnant woman presents with vaginal bleeding, tachycardia, and a woody abdomen. She reports abdominal pain and a drop in fetal heart rate. Considering the possible causes of her condition, which finding would most likely support the diagnosis of placental abruption as opposed to placenta previa?
Explanation
Fetal heart rate variability indicating fetal distress, combined with abdominal pain and uterine tenderness, suggests placental abruption, where the placenta has prematurely separated from the uterus. In contrast, placenta previa typically presents with painless vaginal bleeding and a soft, non-tender uterus.