症例 challenge · Obstetrics / Emergency · teaching

Placental Abruption — Management Pathway · case challenge

Given a case, work through the care pathway step by step; the tool checks each choice and scores you. Decisions and basis are taken from this site's reviewed care pathways.

← View the full flowchartBased on ACOG / Merck

Case #1Obstetrics / Emergency

📋 Case data

Maternal-fetal status & gestational ageMaternal-fetal stable, preterm

Data is taken from this pathway's reviewed node text. Work through the pathway step by step.

Step 1 / 1 · Maternal-fetal status & gestational age

Maternal-fetal status and gestational age?

💡 Premature placental separation at >20 weeks: vaginal bleeding + abdominal pain/uterine tenderness ± contractions + abnormal fetal heart rate; bleeding can be concealed → hemorrhagic shock/DIC/fetal distress and death. Clinical diagnosis (ultrasound is insensitive, normal does not exclude); check coagulation (DIC — fibrinogen may be normal initially, monitor serially), cross-match, fetal monitoring, Kleihauer/anti-D if Rh-negative. Resuscitate and monitor serially in all preterm/suspected cases.

For teaching. Decisions and their basis are taken from this site's reviewed care pathways; for licensed clinicians/trainees, this does not replace clinical judgment or local protocols.