Placental abruption — MCCQE Part 1 MCQ

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EasyPregnancyPlacental abruptionMCCQE Part 1

A 35-week pregnant woman has painful vaginal bleeding after cocaine use; the uterus is tender and rigid and fetal tracing is non-reassuring. Which of the following is the most likely diagnosis?

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Correct answer: A — Placental abruption

Placental abruption is the single best answer because the age, timing, examination findings and investigations in the vignette fit Placental abruption better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to SOGC antepartum haemorrhage guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: SOGC antepartum haemorrhage guidance