Major APH – maternal resuscitation takes priority while the fetal assessment proceeds

A woman at 36 weeks arrives with heavy vaginal bleeding, pulse 130 beats/min and blood pressure 75/45 mmHg. The fetal heart is present. Which approach to fetal assessment is most appropriate during initial management?

A woman at 37 weeks presents with massive antepartum haemorrhage. She is pale and confused, with a pulse of 145 beats/min and blood pressure of 65/35 mmHg. What is the most appropriate immediate vascular-access strategy?

A woman at 27+4 weeks presents with massive antepartum haemorrhage. She is hypotensive and becoming confused. Fetal cardiac activity is present. Her partner asks the team to delay treatment until the neonatal team has assessed the likelihood of intact fetal survival. What is the most appropriate immediate principle of management?

A woman at 36 weeks develops rapidly increasing antepartum haemorrhage with maternal cardiovascular compromise. Which approach to escalation is most appropriate?

A woman at 37 weeks presents with massive APH. She is shocked, with ongoing heavy bleeding while emergency resuscitation is commenced. Which approach to oxygen therapy is most appropriate in this setting?

A woman with ongoing massive APH remains tachycardic and hypotensive despite initial crystalloid resuscitation. Her first haemoglobin concentration is 112 g/L. What is the most appropriate approach to blood replacement?

A woman at 37 weeks has a major APH. Initial measured vaginal blood loss is 650 mL. After intravenous access and initial resuscitation, her pulse remains 132 beats/min, blood pressure is 82/46 mmHg and she becomes increasingly drowsy. Her haemoglobin is 118 g/L. Which parameter should most strongly determine escalation of haemorrhage management?

A woman at 39 weeks presents with catastrophic APH and profound cardiovascular collapse. Two large-bore intravenous cannulae are inserted and blood is sent urgently for cross-match. Despite crystalloid resuscitation, she remains severely hypotensive with continuing haemorrhage. Cross-matched blood is not yet available. Which is the most appropriate transfusion strategy?

A woman at 34+5 weeks presents with sudden severe abdominal pain and vaginal bleeding. Her uterus is tense and tender. Pulse is 142 beats/min, blood pressure 76/42 mmHg and she is confused. CTG demonstrates persistent fetal bradycardia. Ultrasound shows a normally situated placenta without a retroplacental collection. Her initial haemoglobin is 116 g/L. Which single finding should have the least influence on the immediate management strategy?

A woman at 35+5 weeks presents with suspected placental abruption. Approximately 300 mL vaginal blood loss is measured. Pulse is 118 beats/min and blood pressure 94/58 mmHg. Following initial fluid resuscitation, her blood pressure transiently improves to 108/64 mmHg but tachycardia persists. The uterus remains tense and tender and abdominal girth is increasing. Which interpretation should most strongly influence ongoing management?

A woman at 38+4 weeks presents with suspected placental abruption. She has received red cells and plasma for major haemorrhage. Her blood pressure improves from 70/40 to 104/66 mmHg, but vaginal bleeding continues, the uterus remains tense and tender, and her pulse remains 126 beats/min. CTG shows persistent severe fetal compromise. Which interpretation of the apparent haemodynamic improvement is most appropriate?

A woman at 36+4 weeks has a major placental abruption. Following initial crystalloid and red-cell replacement, her blood pressure rises from 74/38 to 106/64 mmHg. However, her pulse remains 134 beats/min, she remains peripherally cool, vaginal bleeding continues and the uterus is tense. Which conclusion is most appropriate?

Select the single most appropriate immediate management principle.

Select the single most appropriate interpretation and response.

Select the single most appropriate immediate priority.

Select the single most appropriate escalation strategy.