A 26-year old having her first baby is 28 weeks pregnant. She experiences bright red, painless vaginal bleeding, soaking one pad. Upon her arrival at the hospital, after placing her on the FHR Monitor, what would be an expected diagnostic procedure?

A. Transverse fetal lie. A transverse fetal lie is related to fetal positioning and is not a direct complication of trauma. While maternal injuries can sometimes lead to abnormal fetal positioning, a car accident does not directly cause a transverse lie.

B. Preterm labor. Trauma, including a car accident, can trigger preterm labor due to stress, uterine irritation, or placental dysfunction. Uterine contractions may begin as a response to the injury, potentially leading to preterm birth.

C. Severe preeclampsia. Preeclampsia is not a direct result of trauma. It is a pregnancy-related hypertensive disorder that develops due to vascular abnormalities rather than external injury. A car accident does not increase the risk of preeclampsia.

D. Placenta previa. Placenta previa is a condition where the placenta covers the cervix, leading to painless vaginal bleeding, but it is not caused by trauma. It is a pre-existing placental abnormality rather than a complication of an auto accident.

E. Placental abruption. Trauma, such as a car accident, significantly increases the risk of placental abruption, where the placenta prematurely detaches from the uterine wall. This can cause vaginal bleeding, abdominal pain, and fetal distress, making it a critical complication to monitor for in a pregnant trauma patient.

A. Maintaining euglycemia in labor reduces the need for insulin postpartum. While insulin requirements typically decrease after delivery due to the loss of placental hormones that cause insulin resistance, the primary reason for tight glucose control during labor is to prevent neonatal complications rather than reducing postpartum insulin needs.

B. A blood glucose level above 110 puts the client at risk for infection in labor. Poorly controlled diabetes can increase infection risk over time, but transient hyperglycemia in labor is not a direct cause of infection. The focus of glucose management during labor is to prevent neonatal hypoglycemia rather than maternal infection.

C. More insulin will be available for fetal use via placental transfer. Insulin does not cross the placenta, so maternal insulin therapy does not provide insulin to the fetus. However, maternal hyperglycemia leads to increased fetal insulin production, which can cause neonatal hypoglycemia after birth.

D. An elevated blood glucose in labor increases the risk of neonatal hypoglycemia. Maternal hyperglycemia causes the fetus to produce excessive insulin in utero. After birth, when the maternal glucose supply is suddenly cut off, the infant’s high insulin levels can cause a rapid drop in blood glucose, leading to neonatal hypoglycemia, which can be dangerous if not managed properly.