Bleeding in Pregnancy – Post Test

A 30-year-old woman presents to the ED with a 6-hour history of vomiting, diarrhoea and abdominal pain. She is 11 weeks pregnant.

She thinks she ate a dodgy curry the night before. She is initially hypotensive. After 2 litres of fluid resuscitation, she has an HR of 95, a BP of 110/60 and an RR of 20. You speak to the gynae ST1 who suggests that she has gastroenteritis and that you send her home.

Which of the following serious differential diagnoses must be actively ruled out before diagnosing gastroenteritis in this patient?

With regard to management of the pregnant patient, which of the following is correct?

Which of the following is not considered to be a reason for bleeding in late pregnancy?

A 32-year-old woman, 36 weeks pregnant, presents to the ED with vaginal bleeding and constant lower abdominal pain. She is pale and anxious. On examination, her uterus is tender and firm, and fetal heart monitoring shows signs of distress.

Which of the following is the most likely diagnosis?

A 29-year-old woman, gravida 3 para 2, presents to the ED at 35 weeks’ gestation with heavy vaginal bleeding. She appears pale, is tachycardic, and her blood pressure is 88/60 mmHg. Fetal heart activity is present on monitoring. Initial resuscitation is started using an ABC approach, and two large-bore IV lines are inserted.

What is the most appropriate next step in management?