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Old 02-17-2011
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Arrow Premature separation of the placenta

A 24-year-old female is in her third trimester and presents with painful vaginal bleeding. She is noted on ultrasound to have premature separation of the placenta from the implantation site. What potential complication would concern you most?


A. Intraperitoneal hemorrhage
B. Preeclampsia
C. Disseminated intravascular coagulation
D. Placenta previa
E. Septic shock
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Old 02-17-2011
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C.) DIC would be of concern. Abruptio Placentae

Last edited by FrontalBossing; 02-17-2011 at 04:11 PM. Reason: I had a brain fart
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Old 02-17-2011
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Default D no C no wait D oh arrrgh!

I can't decide betwee placenta previa and DIC!

I would be worried that she had placenta previa, but is it a complication or is the abruptio placentae the complication? We did an ultrasound so we should have seen previa. DIC is definitely one of the important complications of abruptio placentae... I always choose the wrong answer on questions like this.
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Quote:
Originally Posted by Mondoshawan View Post
I can't decide betwee placenta previa and DIC!

I would be worried that she had placenta previa, but is it a complication or is the abruptio placentae the complication? We did an ultrasound so we should have seen previa. DIC is definitely one of the important complications of abruptio placentae... I always choose the wrong answer on questions like this.
Some key clues are that it's in the 3rd trimester, painful bleeding and also premature separation. Loss of the fetus and DIC are things to worry about with abruptio placentae.

Placenta Previa is painless bleeding, can happen in the 3rd trimester but also in any of the trimesters and it's an attachment issue, not a premature detachment.
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Old 02-17-2011
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the answer is c
the buzzword i think in this ques is PAINFUL ANTEPARTUM haemorrhage,which refers to ABRUPTIO PLACENTA and its complications are dic and hypovolemic shock
PAINLESS antepartum haemorrhage refers to placenta praevia
but in the ques its asked on which complication are u most concerned of.,so i am a bit confused because pre-eclampsia is an etiology for abruptio placenta.,but i still think the answer is c....DIC
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Thank you FrontalBossing and pnreddy! I understand now; I will join you in choosing disseminated intravascular coagulation.
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Who am I to go against DIC........
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Arrow C) Disseminated intravascular coagulation

The correct answer is C) DIC

Did I really confuse you guys. My friend got this one on his real exam. There is only way you can pick up this qn by looking at the buzzwords. The buzzword here is PAINFUL BLEEDING.

This patient has abruptio placentae (premature separation of the placenta from the implantation site). This is sometimes associated with disseminated intravascular coagulation.

Placenta previa presents with PAINLESS bleeding.

Intraperitoneal hemorrhage would be the most feared complication of an ectopic pregnancy.

Septic shock would result from a source of infection, and the question provides no evidence to suggest infection.

Preeclampsia is associated with edema, hypertension and proteinuria.
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