A 34-year-old G3P2 woman at 36 weeks gestation presents to the emergency department with sudden onset, severe abdominal pain and heavy vaginal bleeding. She denies trauma. On examination, her uterus is tender, rigid, and hypertonic. Fetal heart tones show repetitive late decelerations. What is the most likely diagnosis?
✓ Correct Answer: Option D
The classic presentation of abruptio placentae includes sudden onset painful vaginal bleeding, a rigid and tender uterus, and fetal distress (late decelerations) in the third trimester. This distinguishes it from painless bleeding (placenta previa) or less common causes.