Match each third-trimester obstetric clinical presentation with its corresponding underlying pathophysiology.
- Sudden-onset, severe, and constant abdominal pain accompanied by dark vaginal bleeding and a hypertonic uterus.Premature separation of the placenta from the uterine wall
- Painless, bright red vaginal bleeding noted incidentally after intercourse, with a reassuring fetal heart rate tracing.Abnormal placental implantation over the internal cervical os
- Profound fetal bradycardia and bright red vaginal bleeding occurring immediately following spontaneous rupture of membranes.Unprotected fetal vessels coursing through the amniotic membranes
- Sudden cessation of intense uterine contractions, severe focal abdominal pain, and a palpable abdominal mass representing fetal parts.Full-thickness disruption of the uterine musculature
Answer
Sudden-onset painful bleeding matches with premature separation (abruption). Painless bleeding after intercourse matches with abnormal implantation (previa). Bleeding and profound fetal bradycardia at membrane rupture matches with unprotected fetal vessels (vasa previa). Sudden cessation of contractions with palpable fetal parts matches with full-thickness disruption (rupture).
Each clinical scenario uniquely describes the hallmark presentation of a specific obstetric emergency. Painful bleeding points to abruption (premature separation), painless bleeding points to previa (abnormal implantation), bleeding with rupture of membranes and fetal bradycardia points to vasa previa (unprotected vessels), and loss of contractions with palpable fetal parts points to uterine rupture (full-thickness disruption).
Step-by-Step Solution
Key Concept
Clinical differentiation of third-trimester obstetric emergencies
Estimated Time:1m 30s