A 32-year-old pregnant patient at 36 weeks is in active labor and complaining of abdominal pain that has been increasing in intensity and continuous. She denies any bleeding. Abdom... A 32-year-old pregnant patient at 36 weeks is in active labor and complaining of abdominal pain that has been increasing in intensity and continuous. She denies any bleeding. Abdominal examination reveals a 38 cm fundal height, and the uterus is found to be tender and tense. Pelvic examination reveals a 6 cm dilated cervix. Which of the following is the most appropriate next step in management?
Understand the Problem
The question describes a pregnant patient presenting with symptoms suggestive of a potential obstetrical emergency. It asks us to determine the most appropriate next step in her management, given the information provided which includes her gestational age, labor status, pain characteristics, and physical examination findings.
Answer
Prepare for immediate delivery due to suspected placental abruption.
Based on the patient's symptoms (36 weeks pregnant, active labor, increasing and continuous abdominal pain, tender and tense uterus) the most likely diagnosis is placental abruption. The most appropriate next step in management would be to prepare for immediate delivery.
Answer for screen readers
Based on the patient's symptoms (36 weeks pregnant, active labor, increasing and continuous abdominal pain, tender and tense uterus) the most likely diagnosis is placental abruption. The most appropriate next step in management would be to prepare for immediate delivery.
More Information
Placental abruption is a serious condition in which the placenta separates from the wall of the uterus before delivery. This can cause significant bleeding and compromise the oxygen supply to the baby. The continuous abdominal pain, tender and tense uterus are key signs.
Tips
The key to answering correctly is recognizing the signs and symptoms of placental abruption and understanding the need for rapid intervention.
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