- You are the medical officer in charge of a military camp hospital on a UN-manted peace enforcement
- A pregnant woman in her 8th month of pregnancy arrives with a picture of vaginal bleeding, in moderate amount, compatible with placental abruption.
- You have doctors with surgical experience, but you don't have equipment or specialized personnel to care for a premature baby.
- You believe that the detachment is partial, and you can wait for specialist evaluation, but you are not sure, and this condition can progress rapidly at any time and require immediate surgery, with a risk to the life of the pregnant woman and the baby.
- The patient is anxious because it is a very desired pregnancy, but she is clinically stable at that moment and the nearest hospital with obstetric resources is 150 km away.
Source: Report from course participant
Questions for the discussion of this scenario
Do you authorize the surgery to be performed at the field hospital or do you refer the patient in the ambulance to a hospital with obstetric facilities?