ob q - snowblack

[ArchivalUser]

Mrs Betty Johnson is a 20 yo F G2P1, visits your office at 28 wks gestation. She is visiting you for her antenatal care. Betty complains of heaviness in her lower abdomen. She also c/o vague irregular lower abd pains that started since 2 weeks and some spotting.
Ultrasound suspects Type 2 placenta previa.
During your physical exam, you should :

a) use speculum to examine the cervix
b) use bimanual virginal exam
c) reassure and send her home on light physical cativity without physical exam
d) admit her into your hospital unit
e) prepare her for emergency c. section

[ArchivalUser]

cc

[ArchivalUser]

28 weeks, type 2, no bleeding can go home, use to treat in hospital but not anymore

C?

[ArchivalUser]

d.admit her into your hospital unit...

[ArchivalUser]

The answer is "a"

[ArchivalUser]

the key is to make sure there is no bleeding and then what after checking the cervix with speculum?

What is the source of this qs?, it doesn't seem step1!

Thanks.

[ArchivalUser]

since she has vague abdominal pain, one should make sure that labour did not start, so check cervix for bleeding and os opening.

[ArchivalUser]

You are right okt3, the key is to avoid bleeding in this previa patient.
She has type 2 previa which can be delivered virginally if labor ensures. In this preterm patient we want to make sure she has not dilated and effaced.
The only best way to do so is by gentle speculum exam. Bimanual without visual can result in massive bleeding.

The answer is "a"

[ArchivalUser]

answer will be D, admit her in hospital....PP patient with spotting, slight bleeding should be kept under observation and strictly no P/V no P/S

[ArchivalUser]

spssps, remember the client has placenta previa which can present with painless bleeding without cervical dilatation. Since patient has pain, she may be getting into preterm labor, so we must check her cervix for effacement and dilatation; if present, then admit. If not, send home on bed rest.

answer is "a"