Your patient is the 24-year-old female driver of a vehicle in a motor vehicle collision. She rear-ended a vehicle stopped at a traffic light at about 25 miles per hour. She was restrained, and the front airbags deployed. She is 32 weeks pregnant. She is anxious because she has not felt the baby move since the impact, and she is complaining of constant pain on the left side of her abdomen. Palpation of the abdomen reveals unusual firmness over the left side of the abdomen. The patient has a pulse of 116, a blood pressure of 92/60, and respirations of 28. Her skin is cool but dry, and she has no other complaints. For which of the following should you have the highest index of suspicion?

Question

Quizplus · Accepted Answer

The constant pain on the left side of her abdomen and the unusual firmness upon palpation indicate a possible abruptio placentae, which is a serious condition that requires immediate medical attention. The fact that she has not felt the baby move since the impact is also concerning. This condition involves the premature separation of the placenta from the uterus, which can lead to fetal distress and even fetal death if not treated promptly. The patient's vital signs suggest that she is experiencing shock, which can also indicate severe bleeding. Placenta previa and placenta accreta are also serious conditions but are less likely given the patient's presentation. Stress-induced onset of labor is a possibility, but it is less concerning than abruptio placentae and requires further evaluation. The patient's condition should be treated as a medical emergency, and she should be transported to the hospital as soon as possible for evaluation and management.

Your Patient Is the 24-Year-Old Female Driver of a Vehicle