Author: William Wilson, Ulrike Jacobs / Editor: Nick Tilbury / Codes: ObC1, ObC2, ObP1, ObP2, ObP3, SLO1, SLO2, SLO3 / Published: 13/10/2023
A 27-year-old lady at gestational age of 12 weeks (G2P1L1) presents to the Emergency Department (ED) with complaints of vaginal spotting for two days.
She tells you the bleeding has slowly worsened over the last two days and she has now started passing some clots. The bleeding is associated with cramping lower abdominal pain. She denies any nausea, vomiting, bowel or bladder change and has not experienced similar symptoms during previous pregnancies.
Her observations are as follows:
- HR – 44
- BP 72/46
- RR – 26
- SpO2 – 99 o/a
- Temperature – 37.2
On examination you note she is cool and clammy and looks unwell.
She has a normal abdominal contour, her abdomen is not distended but is mildly tender on deep palpation in the suprapubic region. Bowel sounds are normal and there is no guarding or rigidity.
Module Content
Bleeding in Pregnancy
This session covers the emergency management of both bleeding in early pregnancy and antepartum haemorrhage (APH) Appropriate investigation and initial emergency interventions are considered including rhesus status and the administration of anti-D immunoglobulin.
Vaginal Bleeding in the Non-Pregnant Patient
This session covers the relevance of vaginal bleeding in an Emergency Medicine context
Cervical Spine Injury
Cervical spine injuries are rare but potentially devastating. Immobilisation of the cervical spine on the slightest suspicion of injury is recommended by most resuscitation courses.
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