Which finding is most consistent with placental abruption?

Which finding is most consistent with placental abruption?

• A. Dark red vaginal bleeding with a tense uterus
• B. Painless bright red bleeding with a soft uterus
• C. Dark red vaginal bleeding with a uterus that is not tender
• D. Normal fetal heart rate with no bleeding

Answer: (C)

Placental abruption is typically suggested by painful vaginal bleeding with a uterus that is tender and often firm or rigid due to uterine contractions and placental separation. The pain and the tense uterus reflect the ongoing separation and uterine activity in response. When bleeding is dark red and the uterus is not tender, that pattern fits more with placenta previa, which presents as painless bleeding with a soft, non-tender uterus. So the finding described—dark red vaginal bleeding with a uterus that is not tender—does not align with the usual presentation of placental abruption and points more toward previa. In abruption you’d also expect possible fetal distress and maternal signs of hemorrhage, with a uterus that may feel firm or hypertonic.

Placental abruption is typically suggested by painful vaginal bleeding with a uterus that is tender and often firm or rigid due to uterine contractions and placental separation. The pain and the tense uterus reflect the ongoing separation and uterine activity in response. When bleeding is dark red and the uterus is not tender, that pattern fits more with placenta previa, which presents as painless bleeding with a soft, non-tender uterus. So the finding described—dark red vaginal bleeding with a uterus that is not tender—does not align with the usual presentation of placental abruption and points more toward previa. In abruption you’d also expect possible fetal distress and maternal signs of hemorrhage, with a uterus that may feel firm or hypertonic.