Acute intrapartum obstetric emergencyBMJ 2008; 337 doi: https://doi.org/10.1136/bmj.a1940 (Published 22 October 2008) Cite this as: BMJ 2008;337:a1940
- Sharon R Sheehan, research fellow1,
- Helen M McMillan, consultant in obstetrics and gynaecology2,
- Deirdre J Murphy, professor of obstetrics and gynaecology1
- 1Coombe Women and Infants University Hospital, Dublin 8, and Trinity College Dublin, Ireland
- 2Coombe Women and Infants University Hospital
- Correspondence to: S R Sheehan
A 30 year old primigravida was admitted in spontaneous labour at term. Vaginal bleeding was seen after spontaneous rupture of the membranes, and shortly afterwards a profound fetal bradycardia was recorded on cardiotocography. A “crash” emergency caesarean section was performed with delivery of a live male infant in good condition, weighing 3620 g. Apgar scores were 9 at one minute and 10 at five minutes with normal paired cord blood samples. Figure 1⇓ shows the placenta after delivery.
1. What is the diagnosis?
2. What is the ideal emergency management?
3. What risk factors are associated with this condition?
1. Rupture of a vasa praevia is the most likely diagnosis.
2. The patient should …