A 30-year-old G4P3 at 36 weeks presents with severe abdominal pain, vaginal bleeding, and a rigid tender uterus. Fetal heart rate shows late decelerations. Coagulation studies show platelets 80,000/μL and fibrinogen 150 mg/dL. The most likely diagnosis is:

• A Placenta previa
• B Uterine rupture
• C Ectopic pregnancy
• D Abruptio placentae with consumptive coagulopathy ✓

Explanation

Severe abruption causes concealed hemorrhage, uterine rigidity, fetal distress, and disseminated intravascular coagulation with thrombocytopenia and hypofibrinogenemia. Placenta previa is painless. Uterine rupture presents with loss of station and prior scar history, not coagulopathy at presentation.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.