SBA — Single Best Answer · Review
Question 79
Delivery suite → Haemorrhage
Classification
Question
SSBAQuestion Header
A woman at 34 weeks presents with vaginal bleeding and abdominal pain. Which abdominal finding most strongly supports placental abruption rather than placenta praevia?
Question Stem
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Options
A
Soft non-tender uterus
B
High presenting part
C
Transverse fetal lie
D
Tense tender uterus
E
Easily palpable fetal parts
Explanation
Placental abruption classically presents with abdominal pain and uterine tenderness, and the uterus may become tense or “woody” when the abruption is significant. Placenta praevia more typically causes painless bleeding and may be associated with malpresentation or a high presenting part. Clinical findings are important because placental abruption is principally a clinical diagnosis and may occur despite non-diagnostic ultrasound findings.
Option Validity
A) a soft non-tender uterus is less characteristic of placental abruption.
B) a high presenting part can occur with placenta praevia and does not specifically support abruption.
C) transverse lie is associated with abnormal placental location rather than being a characteristic sign of abruption.
E) easily palpable fetal parts do not provide the characteristic evidence of uterine irritability and tenderness seen with abruption.
Further Reading
RCOG Green-top Guideline No. 63. Antepartum Haemorrhage. 2011.