placental abruption

A 31-year-old G3P2 female at 32 weeks gestation is brought in by EMS after a fall with complaint of lower abdominal pain. Exam reveals gravid abdomen with lower abdominal tenderness and no signs of bruising. External pelvic exam shows no signs of trauma, but there is scant blood at the introitus. Fetal heart rate is measured at 110 bpm with bedside ultrasound. What is the patient’s diagnosis? What is the next step in your evaluation and treatment?

Welcome back to the EM Educator Series! This week we look at the challenging and frightening case of the pregnant trauma patient.