Complications during pregnancy Quiz: Ace Your Exams
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A 37-year-old woman, gravida 4 para 3, comes to the labor and delivery unit at the 38 weeks gestation due to vaginal bleeding. She did not receive any prenatal care during this pregnancy. The patient’s first 2 children were born through normal vaginal delivery, while her last child was delivered through C-section due to second stage arrest. She is in good health and takes no medications other than prenatal vitamins. The patient’s temperature is 37.0°C (98.6°F), pulse is 90/min, and blood pressure is 135/85 mmHg. Fetal heart rate is 85/min and fetal heart rate tracing shows a sinusoidal pattern. On physical examination, the patient is in no acute distress. The uterus is non-tender on palpation. Speculum examination reveals ruptured membranes, closed cervix, and profuse bleeding from the cervical os. Which of the following is the most likely diagnosis?
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