Question

Mary Healy, a young woman with severe vaginal bleeding, is admitted to the emergency room. She is three months pregnant. Mary reports having changed her sanitary napkin 4 times in the past hour before coming to the ER.
a. What is the doctor’s immediate concern?
b. In an emergency situation, what blood type may be given to Mary without concern for a coagulation reaction?
c. What blood test will need to be performed if the blood loss continues and more transfusions are needed?

Answer 1

Answer:

The presence of spotting, or some bleeding, during the first trimester of a pregnancy, is normal, as the placenta attaches itself on the uterine wall. However, there must never be severe bleeding, or pain. In the case of Mary Healy, she is presenting severe bleeding at her 3rd month of pregnancy, to the point that she has had 4 sanitary napkins used in an hour. Therefore, the doctor will have to:

a) The doctor will be concerned about three possible scenarios: the first, a miscarriage, which often happens during these first three months of pregnancy, and come with heavy bleeding depending on the type of miscarriage. The second scenario, is an ectopic pregnancy, which is a very serious case that requires emergency intervention. The third is infection, which could have caused a possible abortion.

b) The blood type that can be given to Mary Healy in an emergency situation is a complete packed red blood cell transfusion of O Rh negative type. This type is called the universal donor an it is because it is the least likely to cause an immune response from the host, when transfused.

c) The tests performed in blood work for women who present heavy bleeding during the first trimester of their pregnancy include the blood type to see if there is incompatibility, and also to evaluate the levels of pregnancy hormones. The blood type tests will also allow to know the reaction of the body to multiple transfusions, and there will possibly be a test for blood clotting factors.