QuestionSBA
QuestionChoice
This may be useful if we are considering disseminated intravascular coagulation but there is nothing to suggest this at present.
10034960
d
INR, Fibrinogen and Fibrinogen degradation products
QuestionChoice
This is useful as the patient is actively bleeding and may require transfusion if the haemoglobin drops but the bleeding is light at present and this is not the priority at present as the mother is haemodynamically stable.
10034959
c
Full blood count
QuestionChoice
Whilst this most certainly would be performed to assess the bleed, it is less useful (and insensitive) in cases where there is concealed abruption or retroplacental abruption (up to 25%) which is out of proportion with blood loss and therefore must be considered with CTG and in the overall clinical picture.
10034958
b
Transabdominal ultrasound
QuestionChoice
This is correct. This scenario describes placental abruption with painful antepartum haemorrhage. Management depends on the stability of the mother and foetus and gestational age. If the pregnancy is over 34 weeks and the mother is contracting or bleeding, vaginal delivery is recommended (with possible induction). If the gestation is less than 34 weeks, the mother should be admitted with regular ultrasonography and CTG with steroids considered. CTG is the most useful measure of the stability of the baby here and can inform management thereafter.
10034957
a
Continuous foetal heart rate monitoring
QuestionChoice
CT tends to be avoided in pregnancy as much as possible due to the radiation exposure. It may however be required in cases of traumatic abruption when an ultrasound is inconclusive.
10034961
e
Abdominal CT
QuestionComment
Do you not need to do an ultrasound to be sure that it is placental abruption?
49772
QuestionComment
You don’t diagnose abruption on USS, it’s a clinical Dx. USS is used in these cases to exclude placenta praevia
51916
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Chronic Bradykinin
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Contusion Kawasaki
Concept
Chapter
2693
6110
Placental Abruption
Topic
333
Obstetrics and Gynaecology
19395
Continuous fetal heart rate monitoring is essential in assessing the wellbeing of the fetus in cases of suspected placental abruption.
A 36-year-old G3P2 who is 27 weeks pregnant comes to the maternal assessment unit with lower back pain and light vaginal bleeding which started a few hours ago. On examination, a tender uterus is palpated. She is haemodynamically stable.

Which of the following investigations will prove most useful to guide management?
a