Which finding is characteristic of placental abruption?

• A. Gradual painless vaginal bleeding
• B. Absence of vaginal bleeding
• C. Fetal heart rate remains normal
• D. Sudden onset of severe abdominal pain with signs of shock and a rigid uterus

Answer: (D)

Placental abruption happens when the placenta starts separating from the uterine wall prematurely, causing painful vaginal bleeding, uterine tenderness, and sometimes a rigid, tender uterus as the uterus contracts against the bleeding. The hallmark is sudden, severe abdominal pain with signs of maternal shock from hemorrhage and fetal distress. That combination—sudden intense pain, shock signs, and a rigid uterus—is what makes this finding characteristic.

Think of how this contrasts with other scenarios: gradual painless bleeding fits placenta previa, not abruption; no vaginal bleeding makes bleeding at all unlikely; and a normal fetal heart rate is less consistent with abruption, which often causes fetal compromise. In short, the abrupt, painful presentation with a tense uterus and maternal instability best matches placental abruption.