G2P1LOD1 with 34wks 2ds pregnancy came to ER with bleeding PV and mild pain in the lower abdomen of 10 min duration. Her antenatal checkups were completely normal, with normal TIFFA and fetal echo. Patient's first delivery was through LSCS, the baby died in neonatal period due to Tetralogy of Fallot. On examination, BP was normal, no tachycardia, no pedal edema. P/A - uterus 34wks, not tense, no tenderness, FHS - 146 /min. CTG - reactive. PV - cervix long posterior, os closed. Glove stained with fresh blood.
USG for fetal doppler - normal AFI - 16. Placenta anterior, upper segment with no signs of separation. CUE - Normal, Hb - 11. We gave inj betnesol, Inj augmentin, inj tranexamic acid, inj paracetamol and decided to observe. The patient was monitored with continuous CTG and vitals. Her pain abdomen subsided, however, she continued to have bleeding PV. About after 8 hrs, she had…
