system
Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.
user
A 31-year-old G3P0 is admitted to the hospital with profuse vaginal bleeding and abdominal pain at 34 weeks gestation. She reports passing bright blood with clots and no water in the discharge. She denies recent trauma or medical illnesses. She had no prenatal care. Her previous pregnancies culminated in spontaneous abortions in the second trimester. She has a 6-year history of drug abuse and cocaine smoking 2 hours prior to the onset of her symptoms. Her blood pressure is 160/90 mm Hg, the heart rate is 93/min, the respiratory rate is 19/min, and the temperature is 36.9℃ (98.4℉). The fetal heart rate is 110/min. On examination, the patient is lethargic. Her pupils are constricted, but reactive to light bilaterally. There are no signs of trauma. Abdominal palpation identifies lower abdominal tenderness and strong uterine contractions. The fundus of the uterus is between the xiphoid process and umbilicus. The patient’s perineum is grossly bloody. On pelvic examination, the vaginal canal is without lesions. The cervix is almost completely effaced and 2 cm dilated. Which of the following options is the most likely cause of the patient’s pregnancy-related condition?
assistant
Abrupt constriction of maternal and placental vessels