Antepartum haemorrhage: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Antepartum haemorrhage

Sample item

A hypertensive woman at 35 weeks has sudden constant abdominal pain and dark vaginal bleeding. The uterus is hard and tender, and the fetal heart rate is abnormal. What is the most likely diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Placental abruption

Premature separation of a normally sited placenta causes pain, a tense uterus and fetal compromise, with bleeding that may be concealed. Hypertension is a recognised risk factor. Placenta praevia is painless with a soft uterus.

Option by option

  • A. Cervical ectropion bleeding

    Ectropion gives minor contact bleeding without pain or fetal distress.

  • B. Placental abruption (correct)

    Correct. A tender woody uterus with fetal distress and hypertension point to abruption.

  • C. Placenta praevia

    Praevia presents with painless bright bleeding and a relaxed uterus.

  • D. Vasa praevia

    Vasa praevia causes bleeding at membrane rupture with rapid fetal compromise, but not a tender, hard uterus.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More OBG questions

Questions about this OBG question

What is the answer to this OBG question?

The best answer is B, Placental abruption. Premature separation of a normally sited placenta causes pain, a tense uterus and fetal compromise, with bleeding that may be concealed.

Why is "Cervical ectropion bleeding" not the answer?

Ectropion gives minor contact bleeding without pain or fetal distress.

Why is "Placenta praevia" not the answer?

Praevia presents with painless bright bleeding and a relaxed uterus.

Why is "Vasa praevia" not the answer?

Vasa praevia causes bleeding at membrane rupture with rapid fetal compromise, but not a tender, hard uterus.

What concept does this question test?

It tests Antepartum haemorrhage in OBG. Hypertension is a recognised risk factor. Placenta praevia is painless with a soft uterus.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Antepartum haemorrhage?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.