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Placental abruption — MCCQE Part 1 MCQ

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HardVaginal BleedingPlacental abruptionMCCQE Part 1

A 29-year-old woman at 36 weeks gestation presents with painful vaginal bleeding after cocaine use. The uterus is tender and firm and fetal tracing shows recurrent late decelerations. Which of the following is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Placental abruption

Painful bleeding with a tender hypertonic uterus and fetal distress is classic placental abruption. Placenta previa usually causes painless bleeding with a soft uterus. Abruption requires urgent maternal resuscitation and obstetric delivery planning depending maternal-fetal status.

Reference: SOGC antepartum haemorrhage guidance; provincial obstetric emergency pathways