Delivery
- In Mrs G's case there were concerns on CTG in addition to significant pain and bleeding, plans were made for immediate delivery by emergency caesarean section within 30 minutes (category 1)
- A baby boy was admitted for monitoring to the NNU but was doing well (Apgars 5 at 1 min and 7 at 5 min and 9 at 10 min)
- Umbilical cord gases were obtained (a pH 7.13, v pH 7.21) and cord blood obtained to assess whether Mrs G required further Anti D as she was Rhesus negative (she had routine Anti D 1500iu at 28 weeks)
- Retroplacental clot was noted in keeping with placental abruption
- Estimated blood loss was 1.6 litres and she was admitted to recovery for close monitoring.
Observations were undertaken every 15 min, hourly urine volumes recorded, vaginal blood loss (lochia) monitored and a prophylatic Syntocinon infusion commenced - Bloods had been planned for repeat in 4 hours and if bleeding settled a plan had been made to commence Dalteparin once daily for 10 days to reduce risk of venous thromboembolism
