NREMT Emergency Medical Technician (EMT) Cognitive ExamMedical EmergenciesMedium

A 28-year-old female, 36 weeks pregnant, presents with sudden onset of severe, constant abdominal pain, dark red vaginal bleeding, and a rigid abdomen. She denies trauma. Her vital signs are BP 90/60 mmHg, HR 120 bpm, RR 24 bpm. What is the MOST likely cause of her condition?

  1. AEctopic pregnancy
  2. BPlacenta previa
  3. CPreeclampsia
  4. DAbruptio placentae
Show answer & explanation

Correct answer: D. Abruptio placentae

The symptoms of severe, constant abdominal pain, dark red vaginal bleeding, and a rigid abdomen in a pregnant patient, especially with signs of shock, are classic for abruptio placentae. This is a life-threatening emergency for both mother and fetus.

Why the other options are wrong

  • A. Ectopic pregnancy occurs early in pregnancy and would not present at 36 weeks gestation.
  • B. Placenta previa typically presents with painless, bright red vaginal bleeding.
  • C. Preeclampsia is characterized by high blood pressure and protein in the urine, not typically severe abdominal pain with dark vaginal bleeding and a rigid abdomen.

Abruptio Placentae

A serious pregnancy complication where the placenta separates prematurely from the inner wall of the uterus before birth, leading to bleeding and potential fetal distress.

  • Symptoms include sudden, severe, constant abdominal pain.
  • Often associated with dark red vaginal bleeding and a rigid 'board-like' abdomen.
  • Can lead to maternal hypovolemic shock and fetal compromise.

Memory trick: Painless Bright or Painful Dark?

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