A 28-year-old primigravida at 38 weeks presents in active labor. After spontaneous rupture of membranes, she develops sudden severe fetal bradycardia (60 bpm) and moderate vaginal bleeding. The most likely diagnosis is:
- A Placental abruption
- B Uterine rupture
- C Vasa previa ✓
- D Placenta previa
Correct answer: C. Vasa previa
Explanation
Vasa previa presents with painless vaginal bleeding and sudden fetal bradycardia immediately after membrane rupture, as fetal vessels tear. Abruption causes painful bleeding with fetal distress but not specifically after membrane rupture. Uterine rupture causes maternal pain and fetal distress. Placenta previa causes painless bleeding without acute fetal bradycardia at membrane rupture.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.