A 32 weeks pregnant lady presents in emergency room with continuous bleeding per vaginum. The uterus is painful and tender. Most likely diagnosis is: September 2007

Ans. D: Accidental Hemorrhage Bleeding in abruption placentae is painful and continuous Bleeding in circumvallate placenta is slight. Women with placenta pre often present with painless, bright red vaginal bleeding. This bleeding often stas mildly and may increase as the area of placental separation increases. Prae should be suspected if there is bleeding after 24 weeks of gestation. Abdominal examination usually finds the uterus non-tender and relaxed. Leopold's Maneuvers may find the fetus in an oblique or breech position or lying transverse as a result of the abnormal position of the placenta. Prae can be confirmed with an ultrasound. Rupture of membranes presents with watery discharge per vaginum.