A 30-year-old G2P1 with severe preeclampsia at 32 weeks develops sudden severe epigastalgia, generalized edema, and dark vaginal bleeding. Platelet count is 80,000/cmm, AST 350 U/L, LDH 1200 U/L. The most likely cause of hemorrhage is:
- A Abruptio placentae with HELLP syndrome ✓
- B Uterine atony
- C Placenta previa
- D Vasa previa rupture
Correct answer: A. Abruptio placentae with HELLP syndrome
Explanation
Severe preeclampsia with epigastric pain, elevated transaminases, and thrombocytopenia is HELLP syndrome. It commonly causes DIC and triggers abruptio placentae, which presents with painful dark vaginal bleeding. Placenta previa is painless bright red bleeding without coagulopathy. Vasa previa causes fetal distress, not maternal DIC.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.