Scattered

Blood & Lymphoreticular System


{"ops":[{"insert":"Diagnosis and reasoning"},{"insert":"\n","attributes":{"header":1}},{"insert":"This lady has presented with clinical features of placental abruption; this diagnosis is confirmed by the ultrasound scan.\n\nThere is cardiotocographic evidence of fetal distress; but even more importantly, there is obvious maternal distress, with her vital signs indicating the presence of grade III hypovolemic shock.\n\nShe needs immediate resuscitation, including administration of high flow oxygen to maintain an oxygen saturation of over 95%, and a blood transfusion. This should be followed by urgent delivery via cesarean section (as the cervix is unfavorable).\n\nA full blood count and coagulation profile should be ordered in parallel, and corticosteroids administered to promote fetal lung maturity (these may confer some benefit, even during such a short time period).\n\nHowever, the test results reveal a deranged coagulation profile; in the context of an obstetric emergency, this is suggestive of disseminated intravascular coagulation (DIC); this is confirmed by the presence of elevated "}]}

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