Placental abruption – clinical diagnosis outweighs a negative ultrasound

A 35-year-old woman at 36+2 weeks presents with sudden abdominal pain and vaginal bleeding. The uterus is tense and tender. CTG shows fetal tachycardia with recurrent late decelerations. Ultrasound shows a normally situated placenta with no retroplacental clot. What is the most appropriate interpretation?

A woman at 35 weeks presents with severe constant abdominal pain and only 50 mL of visible vaginal bleeding. She is pale, tachycardic and hypotensive, and her uterus is tense and tender. Which interpretation best explains the discrepancy between her clinical condition and measured vaginal blood loss?

A woman at 34 weeks presents with vaginal bleeding and abdominal pain. Which abdominal finding most strongly supports placental abruption rather than placenta praevia?

A woman at 35 weeks presents with abdominal pain, vaginal bleeding and uterine tenderness. Placental abruption is suspected. A Kleihauer test demonstrates no significant fetomaternal haemorrhage. Which interpretation is most appropriate?

A woman at 36 weeks presents with vaginal bleeding. Which additional symptom most strongly increases clinical suspicion of placental abruption?

A woman at 34 weeks presents with severe constant abdominal pain after a small amount of vaginal bleeding. Her uterus is tense and tender. Pulse is 124 beats/min and blood pressure is 88/54 mmHg. The sanitary pad contains approximately 40 mL of blood. Which interpretation should most strongly guide management?

A woman at 35 weeks has painful APH and uterine tenderness. Ultrasound shows no retroplacental clot. The reported sensitivity of ultrasound for detecting retroplacental clot in placental abruption is approximately 24%, although specificity is high. Which interpretation is most appropriate?

A woman at 36 weeks presents with sudden abdominal pain and a small amount of vaginal bleeding. Her uterus is tender and persistently tense. CTG shows fetal tachycardia with recurrent decelerations. Ultrasound demonstrates an anterior placenta clear of the cervix but no retroplacental collection. Kleihauer testing is negative. Which combination of findings should carry the greatest diagnostic weight?

Two women at 35 weeks present simultaneously with APH. Woman 1 has 900 mL measured vaginal blood loss, pulse 96 beats/min, blood pressure 118/72 mmHg and a soft non-tender uterus. Woman 2 has 120 mL measured vaginal blood loss, pulse 136 beats/min, blood pressure 78/44 mmHg and a tense, tender uterus. Which interpretation is most appropriate?

A woman at 34 weeks has painful APH and uterine tenderness. Ultrasound demonstrates a retroplacental collection. In another woman with an almost identical presentation, ultrasound is normal. Which statement best explains how these results should alter diagnostic reasoning?

Select the single most likely cause of the antepartum haemorrhage.

Select the single most likely cause of the antepartum haemorrhage.

Select the single most appropriate interpretation of the investigation result.

Select the single most appropriate interpretation of the severity of haemorrhage.

Select the single most appropriate diagnostic interpretation.

Select the single most appropriate diagnostic interpretation.

Select the single most appropriate interpretation of the ultrasound findings.

Select the single most appropriate diagnostic interpretation.