Bleeding in Pregnancy Case 2

1. Question

A 35-year-old primigravida, rhesus negative woman presents to the ED following a domestic incident in which she alleges she was punched in the stomach. She thinks she is about 11 weeks pregnant. She has abdominal cramps but no PV loss. She is tachycardic at 110 bpm, but all other observations are within normal range.

Briefly describe your initial management.

2. Question

You decide she needs anti-D immunoglobulin. How much are you going to give and by what route?

250 iu IM to the deltoid muscle
250 iu IV
500 iu IM to the deltoid muscle
500 iu IV
250 iu IM to the vastus lateralis muscle
500 iu IM to the ventrogluteal muscle
250 iu PO
500 iu PO

3. Question

The patient tells you she is a Jehovah’s Witness and doesn’t want anti-D immunoglobulin. What do you do?

Bleeding in Pregnancy Case 2

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