Following blunt trauma in late pregnancy, which sign most strongly suggests placental abruption?

• A. Fetal heart rate normal
• B. Bleeding without uterine tenderness
• C. Abdominal tenderness with a rigid uterus
• D. No bleeding

Answer: (C)

Abdominal tenderness with a rigid, board-like uterus is the strongest sign of placental abruption after blunt trauma in late pregnancy. This rigid, tender uterus reflects uterine irritability due to placental separation and concealed bleeding behind the placenta, a hallmark feature of abruption. Other signs are less specific: bleeding without uterine tenderness could point toward placenta previa or a minor bleed, a normal fetal heart rate can occur even with abruption, and no bleeding is not compatible with abruption. So the presence of a tender, rigid uterus best points to placental separation rather than the other scenarios.