This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: FMGE 2019, Subject name: Gynaecology & Obstetrics
32 years old pregnant lady presented with mild bleeding and pain. On examination uterus is tender and fetal hea sounds is absent. What is diagnosis? 
Select and explain. 
A. Abruptio placenta, B. Fetal distress, C. Ectopic pregnancy, D. Placenta Pre
A: Abruptio placenta
Answer: A: Abruptio placenta 
Explanation: The above case history is suggestive ofAbruptio placenta C/F: Bleeding is painful Can be revealed, concealed or usually mixed Dark colored Feel of uterus: May be tense, tender and rigid FHS: Usually absent especially in concealed type Placenta in upper segment Vaginal examination: Placenta is not felt on lower segment. Blood clots should not be confused with placenta Management: At 32 weeks: Resuscitation Steroids to baby Sedation Do ARM and deliver the baby