A woman presented with vaginal bleeding at 39 weeks + 5 days gestation. Booking blood pressure was 123/72 mmHg. Her last midwife visit was 10 days ago when blood pressure was 130/76mm Hg. This evening she noticed a small “gush” of blood and discovered a bright red stain in her underclothes. She denies actual abdominal pain but reports some intermittent abdominal discomfort. The baby has been moving normally during the day. Examination She is warm and perfused.
Her blood pressure is 158/87 mmHg and heart rate 84/min. The symphysiofundal height is 36 cm and the fetus is cephalic with 3/5 palpable abdominally. Moderate uterine tenderness is noted. The uterus is soft but during the palpation two moderate uterine tightening are noted. On speculum examination, the cervical os is closed and there is a moderate amount of vaginal blood. Investigations Urinanalysis: + Protein, + + Blood,…
