Which obstetric emergency presents with painful, dark red vaginal bleeding, a rigid uterus, and risk of fetal hypoxia and DIC?

Which obstetric emergency presents with painful, dark red vaginal bleeding, a rigid uterus, and risk of fetal hypoxia and DIC?

• A. Placental abruption
• B. Placenta previa
• C. Uterine rupture
• D. Vasa previa

Answer: (A)

Premature separation of the placenta from the uterine wall causes this presentation. When the placenta detaches, blood can collect between the placenta and uterus, and the uterus often becomes tense or rigid as it contracts against the bleeding. The bleeding is typically dark red and painful, unlike the painless bleeding seen with placenta previa. The disrupted placental blood flow creates fetal hypoxia, since oxygen and nutrients are no longer efficiently transferred to the fetus. It also raises the risk of disseminated intravascular coagulation because tissue factor from the distressed placental tissue and ongoing bleeding consume clotting factors. This combination of painful bleeding, a firm/rigid uterus, and potential fetal compromise and coagulopathy points to placental abruption.

Premature separation of the placenta from the uterine wall causes this presentation. When the placenta detaches, blood can collect between the placenta and uterus, and the uterus often becomes tense or rigid as it contracts against the bleeding. The bleeding is typically dark red and painful, unlike the painless bleeding seen with placenta previa. The disrupted placental blood flow creates fetal hypoxia, since oxygen and nutrients are no longer efficiently transferred to the fetus. It also raises the risk of disseminated intravascular coagulation because tissue factor from the distressed placental tissue and ongoing bleeding consume clotting factors. This combination of painful bleeding, a firm/rigid uterus, and potential fetal compromise and coagulopathy points to placental abruption.