Which symptom would strongly suggest placental abruption?

Which symptom would strongly suggest placental abruption?

• A. Sudden, painful vaginal bleeding with abdominal pain and a tender, rigid uterus.
• B. Gradual vaginal bleeding with mild cramping and a soft uterus.
• C. Painless vaginal bleeding with no abdominal pain.
• D. Chills and fever with foul-smelling lochia.

Answer: (A)

Placental abruption happens when the placenta separates from the uterine wall prematurely, causing painful bleeding and a high-tension, irritable uterus. The most telling sign is sudden vaginal bleeding that is painful, accompanied by abdominal pain and a uterus that feels tender and rigid. That tense, board-like uterus reflects active uterine contractions and the irritation from bleeding, which is classic for abruption. In contrast, placenta previa typically causes painless vaginal bleeding with a soft, non-tender uterus because the placenta is lower in the uterus and not causing uterine contractions. Fever with foul-smelling lochia suggests an infection such as endometritis, not placental separation. Gradual bleeding with mild cramping and a soft uterus points away from abruptio and toward other obstetric conditions or routine postpartum changes. So the combination of sudden onset bleeding, abdominal pain, and a tender, rigid uterus best indicates placental abruption.

Placental abruption happens when the placenta separates from the uterine wall prematurely, causing painful bleeding and a high-tension, irritable uterus. The most telling sign is sudden vaginal bleeding that is painful, accompanied by abdominal pain and a uterus that feels tender and rigid. That tense, board-like uterus reflects active uterine contractions and the irritation from bleeding, which is classic for abruption.

In contrast, placenta previa typically causes painless vaginal bleeding with a soft, non-tender uterus because the placenta is lower in the uterus and not causing uterine contractions. Fever with foul-smelling lochia suggests an infection such as endometritis, not placental separation. Gradual bleeding with mild cramping and a soft uterus points away from abruptio and toward other obstetric conditions or routine postpartum changes.

So the combination of sudden onset bleeding, abdominal pain, and a tender, rigid uterus best indicates placental abruption.