Presentation
MVA. 19 weeks pregnant. Seatbelt sign over chest, PV blood loss and mild tachycardia.
Patient Data
Chest
No signs of trauma, no pneumothorax, no pleural effusion, no dissection. Heart, great vessels, mediastinal structures, imaged portion of the neck, both lungs, imaged skeletal structures including ribs and thoracic spine are within normal limits.
Abdomen and pelvis
Liver, spleen, both kidneys, great vessels, adrenals, pancreas, gallbladder, biliary tree and urinary bladder are unremarkable.
No free fluid. Uterus is enlarged containing a single foetus of the size of a second trimester gestation. The placenta is anteriorly positioned. Small amount of free fluid in the vagina. The cervix is widened. Fluid between the placental margin and the uterine wall.
Skeletal structures within normal limits, no signs of trauma, no fracture.
IMPRESSION
- Free fluid in the vagina, widened cervix and fluid between the placental margin and the uterine wall in keeping retroplacental hemorrhage/placental abruption and potential miscarriage in progress.
- No intrathoracic or intra-abdominal organ pathology, in particular no signs of trauma.
- No fractures.
Case Discussion
The patient was transferred to the nearest women's hospital. No US or follow-up was available.
CT features highly suggestive of placental abruption.
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