Thanks for listening to the second episode of this 4 part series on one patient's pregnancy. 
Listen to episode 3 first if you have not yet. 
Remember to say your answers out loud and summarize the information you've heard to make this an active learning process. 

Part 2
Imagine now that we have the same otherwise healthy mother who presents at 25 weeks with sudden onset of vaginal bleeding, abdominal pain, and high-frequency, low-intensity contractions every 3 minutes. Exam shows a tender and hard uterus. Her cervix is closed with a speculum exam. Fetal heart tracing is Category 1. CBC shows a slightly worse normocytic anemia, and antibody screen for Rh is still negative. What is the most likely diagnosis?

1. Uterine rupture: 
2. Placental abruption: Correct. Classic clinical presentation. In summary, presenting signs of placental abruption include
    
   • Sudden-onset vaginal bleeding, 
   • Abdominal or back pain,
   • High-frequency, low-intensity contractions, 
   • Rigid & tender uterus. 
3. Sub-chorionic hemorrhage 
4. Concealed uterine abruption

Bonus Question! If this patient had no signs of bleeding, would the diagnosis still likely be placental abruption? 

Part 3

What is the next best step in management?

Part 4
At 28 weeks gestation, she was seen in the office for her regularly scheduled 28-week appointment, and as a part of screening at this time, her blood-work showed anti-D antibody titers are 1:32. What happened? 

Soon we'll have the answers posted online so watch out for updates. 
Thanks for listening!