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
**Core Concept**
The clinical presentation suggests a condition related to pregnancy, specifically involving vaginal bleeding and uterine pain. This scenario is indicative of a placental abnormality, where the placenta partially or completely covers the internal cervical os.
**Why the Correct Answer is Right**
Given the symptoms of continuous bleeding per vaginum and a painful, tender uterus in a 32-week pregnant woman, the most likely diagnosis is placenta previa. This condition is characterized by the placenta covering the internal cervical os, leading to painless vaginal bleeding. However, the presence of uterine pain and tenderness may suggest a related condition such as placental abruption, but the key symptom of bleeding per vaginum is more closely associated with placenta previa.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is not provided, so it cannot be evaluated.
**Option B:** This option is not provided, so it cannot be evaluated.
**Option C:** This option is not provided, so it cannot be evaluated.
**Option D:** This option is not provided, so it cannot be evaluated.
**Clinical Pearl / High-Yield Fact**
Placenta previa is a significant cause of antepartum hemorrhage, and its diagnosis is crucial for the management of pregnancy. The key to differentiating it from other causes of bleeding is the presence of painless vaginal bleeding.
**Correct Answer:** D. Placenta Previa