A 23-year-old pregnant female at 32 weeks gestation complains of severe abdominal pain after a car crash. What should you suspect?

Get ready for the Paramedic Readiness Exam 5. Study with multiple-choice questions, detailed explanations, and effective strategies. Enhance your exam preparedness today!

Multiple Choice

A 23-year-old pregnant female at 32 weeks gestation complains of severe abdominal pain after a car crash. What should you suspect?

In late pregnancy, blunt abdominal trauma most commonly points to placental abruption, when the placenta separates from the uterine wall. This separation causes painful abdominal pain, uterine tenderness or rigidity, and can lead to vaginal bleeding and fetal distress. The scenario—a woman at 32 weeks with severe abdominal pain after a car crash—fits this pattern because the placenta is still attached near the uterine surface and is vulnerable to shearing forces from trauma. Ectopic pregnancy is not plausible at 32 weeks, since implantation occurs far earlier. Labor is possible in the third trimester, but the combination of trauma and sudden, severe abdominal pain with potential placental involvement makes placental abruption more likely. Uterine rupture is a concern, especially if there’s a prior uterine scar, and it presents with abrupt severe pain and fetal distress, but without a scar history, placental abruption remains the most probable diagnosis here. Treat as an obstetric emergency: ensure maternal and fetal monitoring, establish IV access, provide oxygen, and prepare for rapid transport to a facility equipped for delivery.

In late pregnancy, blunt abdominal trauma most commonly points to placental abruption, when the placenta separates from the uterine wall. This separation causes painful abdominal pain, uterine tenderness or rigidity, and can lead to vaginal bleeding and fetal distress. The scenario—a woman at 32 weeks with severe abdominal pain after a car crash—fits this pattern because the placenta is still attached near the uterine surface and is vulnerable to shearing forces from trauma.

Ectopic pregnancy is not plausible at 32 weeks, since implantation occurs far earlier. Labor is possible in the third trimester, but the combination of trauma and sudden, severe abdominal pain with potential placental involvement makes placental abruption more likely. Uterine rupture is a concern, especially if there’s a prior uterine scar, and it presents with abrupt severe pain and fetal distress, but without a scar history, placental abruption remains the most probable diagnosis here.

Treat as an obstetric emergency: ensure maternal and fetal monitoring, establish IV access, provide oxygen, and prepare for rapid transport to a facility equipped for delivery.

More practice questions