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What is A women at 8 months of pregnancy complains of abdominal pain and slight vaginal bleed. On examination the uterus is tender with size more than expected for dates with absent fetal hea sounds. The diagnosis and explain in detail?
This is a case of abruption with concealed retroplacental bleed which makes the uterus tender and also increase the uterine height. Please note that there may be some amount of vaginal bleeding in concealed hemorrhage as well. The uterine tenderness is also because of bruising of the uterine surface. With abruption the fetal hea sounds are often not heard due to the taut abdominal wall and hypeonic uterus, even when the fetus is alive. If the fetal hea rate is normal, the best management here is to induce labour,