Clinical Case 1

A 28-year-old woman self presents to the ED at 35 weeks’ gestation in her first pregnancy with abdominal pain and vaginal bleeding.

At triage her observations are as follows:

HR 120, BP 135/80, oxygen saturation 98% RA, RR 20, temp 36.8°C.

She is moved to ED resus and you are asked to see her whilst the triage nurse contacts the obstetric team.

On further questioning she reports continuous abdominal pain and when asked to quantify the volume of vaginal bleeding reports having soaked several pads within the last 2 hours.

Question 1

What is the most likely cause of her painful vaginal bleeding?

Question 2

What should the initial ED management include?

(More than one answer may be correct)

The same 28-year-old woman who had presented to ED with abdominal pain and vaginal bleeding was stabilised and admitted under the obstetrics team for further observation.

She was diagnosed with placental abruption and once resuscitated was discovered to be hypertensive and subsequently also diagnosed with pre-eclampsia.

Question 3

Name 5 other crises that can occur in pre-eclampsia