A woman at 36 weeks has sudden severe constant abdominal pain, a rigid tender uterus and dark vaginal bleeding. She is hypotensive. What is the likely diagnosis?
Answer and explanation
Correct answer: B. Placental abruption
- Step 1: Painful rigid uterus with dark bleeding and shock suggests abruption.
- Step 2: Concealed haemorrhage can be far greater than visible loss.
Answer
Placental abruption.
Why not the others: Placenta praevia with painless bleeding: Praevia bleeding is painless with a soft uterus. Braxton Hicks contractions of late pregnancy: Braxton Hicks do not cause shock. Vasa praevia presenting with fetal bradycardia only: Vasa praevia bleeding is fetal and not accompanied by a rigid uterus.
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