Monday, July 13, 2009

Decidua

A 30 year old G1P0 woman with hypertension at 28 weeks gestational age presents to the emergency department with vaginal bleeding. She also has acute onset back and abdominal pain and uterine contractions. The uterus feels pretty rigid and tender. The mother admits she smokes and just used cocaine. Here is an ultrasound; unfortunately, one of the labels got smudged:

Challenge: What's the diagnosis?

Image shown under fair use.

3 comments:

Stephanie said...

placental abruption, smudged label should read "blood" between the uterine wall and placenta.

Alex said...

abruptio placenta

Craig Chen said...

too easy, I guess :)
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Decidua

Placental abruption is decidual bleeding leading to premature separation of the placenta prior to delivery of the fetus. Risk factors include trauma, hypertension, premature preterm rupture of fetal membranes, ischemic placental disease, thrombophilia, cigarette smoking, and cocaine. The image shows a retroplacental hemorrhage.

Sources: UpToDate; smbs.buffalo.edu.