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Placental abruption after trauma — DipIMC MCQ

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HardPaediatric and Obstetric EmergenciesPlacental abruption after traumaDipIMC

A 28-year-old woman at 30 weeks' gestation is involved in a road collision. She has abdominal pain, vaginal bleeding and a tender uterus; observations are currently normal. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Treat as major trauma with left uterine displacement and obstetric-capable receiving pre-alert

Abdominal pain and vaginal bleeding after trauma in late pregnancy may indicate placental abruption even when maternal observations initially look normal. Maternal assessment and resuscitation take priority, with left uterine displacement and appropriate obstetric/trauma destination. Fetal movement does not exclude abruption. The pearl is that pregnant trauma patients can hide significant pathology early.

Reference: JRCALC Guidelines 2025; NICE Major Trauma NG39