A hypertensive pregnant woman at 34 weeks comes with history of pain in abdomen, bleeding per vaginum and loss of fetal movements. On examination the uterus is contracted with increased uterine tone. Fetal heart sounds are absent. The most likely diagnosis is:
Ans. is d, i.e. Abruptio placentaRef. Dutta Obs. 7/e. p 255The patient in the question is hypertensive and presenting with:History of pain in abdomen.Bleeding per vaginum.Loss of fetal movements.O/E= uterus is contracted.Increased uterine tone.Fetal heart sounds are absent.All these features confirm the diagnosis of abruptio placenta.As far as premature labor is concerned - Complains of abdominal pain and vaginal bleeding will be present but loss of fetal movement, absence of fetal heart sounds and increased uterine tone go against it. (In normal labor - uterus contracts and relaxes intermittently i.e. tone increases and decreases intermittently).
Placenta previa
Hydramnios
Premature labor
Abruptio placenta
Antepartum Haemorrhage