Vaginal bleeding in a pregnant 32-year-old woman
Case Event
The patient remains in the emergency department awaiting further evaluation. One hour later you are called to reassess the patient who has begun complaining of irregular cramping and contractions that are getting slightly stronger.
Her fetal monitor now shows the following:
- Uterine irritability, few contractions with overall minimal variability and periods of absent variability and recurrent late decelerations.
On the bed pad there is approximately 50 cc bright-red blood.
Repeat vital signs show:
- Temperature: 37.2 C
- Pulse: 98/min
- BP: 127/81 mm Hg
- Respirations: 18/min
With a known fundal placental location, you do an internal exam that shows she is 3-cm dilated with cervix 50% effaced and fetal station -3 and there is scanty visible bleeding from the cervix.