abruptio or rupture ? and why ?

[tyagee]

A 37-year-old patient, gravida VI, para V, in her 38th week of gestation is undergoing elective labor induction. Her pregnancy has been uncomplicated, and she has no history of past serious illness. Her third delivery was via cesarean section, all others were normal spontaneous vaginal deliveries. Fifteen minutes after administration of intravenous (IV) oxytocin, fetal heart monitoring shows prolonged decelerations. Vaginal bleeding is noted, and eight, then ten uterine contractions are documented during two consecutive 10-minute intervals.



A. Abruptio placentae
B. Bloody show
C. Cervical cancer
D. Cervical laceration
E. Hypotonic uterus
F. Placenta accreta
G. Placenta previa
H. Uterine rupture
I. Vasa previa
J. Vulvovaginal candidiasis

[K06100]

vasa previa i think .....triad is --
1.rupture of membranes
2.fetal bradycardia
3.painless vaginal bleeding

no definitely histroy is given to rule out rupture or abruptio placenta......

[stfidel]

She has uterine hyperstimulation from oxytocin by the number of contractions in a 10min observation period....she has a previous CS, Grand multiparous woman...over 35 yrs and on her 6th pregnancy.....all these support a weak uterus and coupled with hyperstimulation...only likely answer is uterine rupture....

[Zamalek]

The most likely answer to this vignette although rare is Vasa previa. This is due to the painless vaginal bleeding coupled with fetal deceleration. Uterine rupture will be unlikely because the patient appears stable and there is no pain mentioned in this vignette...

[tyagee]

Originally Posted by tyagee

A 37-year-old patient, gravida VI, para V, in her 38th week of gestation is undergoing elective labor induction. Her pregnancy has been uncomplicated, and she has no history of past serious illness. Her third delivery was via cesarean section, all others were normal spontaneous vaginal deliveries. Fifteen minutes after administration of intravenous (IV) oxytocin, fetal heart monitoring shows prolonged decelerations. Vaginal bleeding is noted, and eight, then ten uterine contractions are documented during two consecutive 10-minute intervals.



A. Abruptio placentae
B. Bloody show
C. Cervical cancer
D. Cervical laceration
E. Hypotonic uterus
F. Placenta accreta
G. Placenta previa
H. Uterine rupture
I. Vasa previa
J. Vulvovaginal candidiasis

qbank says its uterine rupture because events occuring after oxytocin administration with hyperstimulation of uterine contraction. she having more than 5 contractions in 10 minutes ....
so ?

[stfidel]

Originally Posted by Zamalek

The most likely answer to this vignette although rare is Vasa previa. This is due to the painless vaginal bleeding coupled with fetal deceleration. Uterine rupture will be unlikely because the patient appears stable and there is no pain mentioned in this vignette...

Where did u see it mentioned she had a rupture of membranes,...fetal decelerations is not only unique to vasa previa....and all the risk factors i mentioned is what makes it Uterine rupture...however let tyagee provide the answer.....cheers

[Future Radiolog]

I didn't get it,, why uterine rupture is the answer ??

in uterine rupture there's loss of FHR & cessation of uterine contractions
this patient continued to have contractions after the onset of vaginal bleeding !!!

[absolutjag9]

placentio abruptiae? increased contractions seen there

hypotonic uterus-they dont have contractions..MCC postpartum hemorrhage

uterine rupture-no contractions and lots of pain.

C and D and J make no sense with her clinical pres