Which sign is most consistent with abruptio placentae?

• A. Painless Vaginal Bleeding
• B. Severe Abdominal Pain With Rigid Uterus
• C. Increased Abdominal Tenderness
• D. Fetal Heart Rate Abnormalities

Answer: (B)

Abruptio placentae causes the uterus to become painful and unusually firm due to the placental separation and concealed bleeding inside the uterus. The most characteristic sign is sudden, severe abdominal pain with a rigid or board-like uterus, reflecting uterine hypertonicity and possible concealed hemorrhage. This combination helps distinguish it from conditions that present with painless bleeding, such as placenta previa, where there isn’t the intense abdominal pain and uterine rigidity.

Fetal heart rate abnormalities can occur when the placental separation affects oxygen delivery, but they are not as consistently present as the painful, rigid uterus finding. Increased abdominal tenderness on its own isn’t as specific, and painless vaginal bleeding points toward placenta previa rather than abruptio placentae.