Which symptom is most characteristic of abruptio placentae?

• A. Sharp, Stabbing Pain High in the Uterine Fundus
• B. Rigid Abdomen
• C. Heavy Bleeding May Not Be Readily Apparent (Dark Red)
• D. Increased Uterine Irritability

Answer: (A)

Placental abruption typically causes painful vaginal bleeding with a tender, often rigid, uterus because the placenta is separating and blood is irritating the uterine smooth muscle. The most characteristic sign is a sudden onset of sharp, severe pain that is felt in the fundus, reflecting acute uterine involvement from the placental separation. This pain pattern plus fundal tenderness points to abruptio rather than painless bleeding or a non-tender uterus.

Other signs can occur but are less defining: bleeding may be heavy or concealed if the hemorrhage is internal, and the uterus can become irritable or hypertonic as it tries to contract against the bleed. However, the hallmark feature to recognize is the sudden, sharp pain localized to the fundal area with a tender uterus, signaling abruptio placentae.