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Recurrent preterm abruption--case report.

Year: 2005
Type: article
Study design: Case Report
Abstract: A 30-year-old woman – gravida 3, para 2, living 2 – presented at 32 weeks' gestation with a history of dull aching pain in the abdomen radiating to her back. There was no history suggestive of tightening. There was no history of bleeding per vaginum. Fetal movements were normal. The patient had had 2 previous emergency cesarean sections at 26 and 30 weeks, respectively, as a result of placental abruption. In the current pregnancy, there were no symptoms of headache, flickering in front of eyes, or epigastric pain. On examination, the maternal blood pressure was 110/70 mm Hg and the pulse rate was normal. Reflexes were normal. The baby's growth was monitored at 26 and 30 weeks with growth scans and was reported to be normal. The uterus was relaxed and its size corresponded to the period of gestation. Presentation was cephalic, and the fetal heart was heard. On speculum examination, the cervix was long and closed. There was no bleeding. The patient was admitted to the ward for observation in view of her previous history of abruption. She was given a 12-mg dose of betamethasone (injection) and paracetamol tablets for analgesia. Five hours after admission, she experienced worsening lower abdominal pain. There was no history of bleeding per vaginum. On examination, her pulse rate and blood pressure remained normal, but her abdomen felt very tense. It became difficult to hear the fetal heart with Sonicaide. Cardiotocography was started. A trace was recorded with baseline 140 beats per minute (bpm); accelerations occurred and there were no decelerations, but it was difficult to obtain a consistent trace. The abdomen was very tense and tender on examination; fetal parts were not clearly palpable. There was no change in cervical findings, and an emergency cesarean section was done in response to clinical suspicion of abruption. A live baby was born weighing 1770 g, with an Apgar score of 5 at 1 minute and Apgar 8 at 5 minutes. Retroplacental clots of about 400 g were present. Cord blood pH was 7.277 and 7.302 in the artery and vein, respectively. The patient had an uneventful postoperative period. There was a drop in hemoglobin from 12.1 g/dL to 10.3 g/dL. She was discharged on the third postoperative day. The only medication she received on discharge was iron supplementation (tablets).
Source: PubMed
Language: English
Field: Medicine
Open Access status: green
OpenAlex ID: W40947399
FWCI:
Cites: 7
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Related to: 10