📌 NCLEX Topic: Concealed Bleeding in Pregnancy

Key Concept:

Concealed bleeding occurs when blood accumulates inside the uterus without visible external bleeding. It is commonly associated with placental abruption and poses a severe risk to both the mother and fetus.

Causes & Risk Factors

• Placental abruption (most common cause)
• Trauma (e.g., car accident, domestic violence)
• Hypertension or preeclampsia
• Multiparity
• Cocaine use or smoking
• Previous history of placental abruption

Signs & Symptoms of Concealed Bleeding

✅ Maternal Findings:

• Sudden, severe abdominal pain (constant, not intermittent)
• Hard, board-like abdomen (uterine hypertonicity)
• Increase in fundal height (due to blood accumulation)
• Signs of hypovolemic shock (tachycardia, hypotension, pallor)

✅ Fetal Findings:

• Late decelerations on fetal heart monitoring (due to placental insufficiency)
• Decreased baseline variability (fetal distress)
• Absence of fetal movement (severe cases)

❌ What is NOT a sign of concealed bleeding?

• Heavy vaginal bleeding (this is seen in external hemorrhage)
• Early decelerations (associated with head compression)