TY - CHAP M1 - Book, Section TI - The Adolescent Pregnant Patient A1 - Okada, Pamela J. A1 - Bercaw-Pratt, Jennifer L. A2 - Schafermeyer, Robert A2 - Tenenbein, Milton A2 - Macias, Charles G. A2 - Sharieff, Ghazala Q. A2 - Yamamoto, Loren G. PY - 2014 T2 - Strange and Schafermeyer's Pediatric Emergency Medicine, 4e AB - Ectopic pregnancy, as the leading cause of maternal mortality during the first half of pregnancy, should be considered in patients with abdominal pain and vaginal bleeding.Examination of the cervix may exacerbate hemorrhage in patients with placenta previa.Placental abruption may present with concealed hemorrhage or vaginal bleeding and typically includes vaginal bleeding, abdominal pain, uterine tenderness, and contractions. Ultrasound is not sensitive for its diagnosis.The relatively high prevalence of preeclampsia should warrant obtaining a routine blood pressure and consideration of screening for proteinuria.HELLP syndrome is defined as hemolysis, elevated liver enzymes, and low platelets (<100,000/mm3); lower platelet counts are associated with higher mortality.Shock may be difficult to diagnose in the pregnant patient as blood volume, heart rate, and respiratory rate are physiologically increased during pregnancy. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/10/09 UR - accesspediatrics.mhmedical.com/content.aspx?aid=1105685805 ER -