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1.A 32-year-old woman who is 36 weeks pregnant comes to the labour ward because of upper
abdominal pain and slight vaginal bleeding. Her two previous pregnancies ended in Caesarean
section because of placental abruption. She has a normal blood pressure (BP) and a reactive non-
stress test. What are her chances of having another placental abruption?CorrectIncorrect
- A 29-year-old pregnant woman has just booked for her antenatal care. Her first pregnancy ended in a Caesarean section birth because of placenta praevia. What are her risks (odds ratio, OR) for a recurrence?
- A non-sensitized Rh-negative pregnant woman is admitted at 34 weeks with a moderate amount of vaginal bleeding. She is stable and the bleeding has stopped. What specific test should you request?
- A 33-year-old woman who is 33 weeks pregnant is admitted with severe abruption and an estimated blood loss of 1500 mL. An emergency ultrasound scan showed a large retroplacental haematoma. Fetal heart pulsations were not seen on the ultrasound scan. She is stabilized with intravenous saline infusions and prepared for an emergency Caesarean section. What is your first line empirical treatment while waiting for the coagulation profile results?
5.A woman is noted to have a low-lying placenta at her 20-week anomaly scan. At what gestational age eshould you arrange the next scan to assess placental localisation?CorrectIncorrect
6.What is the usual method of diagnosing placental abruption?CorrectIncorrect
- A primigravida with a low-risk pregnancy is admitted at 30 weeks with an antepartum haemorrhage (APH). A diagnosis of placental abruption has been made. The bleeding settled with conservative management and she is discharged home. What is the most appropriate plan for her further antenatal care?
- A primigravida is seen in the antenatal clinic. A routine mid trimester anomaly scan at 20 weeks reveals an anterior placenta covering the os. What is the most appropriate management?
- A gravida 3 Para 2 is diagnosed with an anterior placenta reaching to the os at 20 weeks. She has had 2 previous caesarean sections. What further investigation would you arrange?
- You are preparing for the caesarean section of a multipara with central placenta previa. She is not anaemic, is haemodynamically stable and has never had any epi- sode of vaginal bleeding. At least how many units of cross matched blood should be kept ready for use in anticipation of intraoperative blood loss?
- A 24-year-old woman is 22 weeks pregnant in her second pregnancy. She has had one previous caesarean delivery. Her routine 20-week obstetric ultrasound revealed a low-lying anterior placenta, partially covering the cervical os. Which SINGLE action is most appropriate?
- You are about to counsel a woman with major placenta previa at 32 weeks who has just had a repeat scan for placental localisation. The ultrasound scan shows an ante- rior placenta covering the internal os with irregular retroplacental sonolucent zone and hypervascularity in serosa-bladder interface. Fetal parameters are appropriate for gestational age. She had her previous caesarean section for breech presentation 4 years back and has not had any episodes of bleeding in this pregnancy. What is the most appropriate course of action?
- The percentage of recurrence of placental abruption with one abruption?