Sudden Severe Lower Abdominal in Obstetrics & Gynecology — Case | General Gynecology | SMLE Q#11767

SMLE Question #11767

Obstetrics & Gynecology General Gynecology

Objective: OBJ-ETH-STERIL

Last updated: February 2026
A 29-year-old G2P1 woman at 33 weeks’ gestation presents with sudden severe lower abdominal pain and moderate vaginal bleeding for 2 hours. She feels dizzy and reports decreased fetal movements. She is pale and diaphoretic. The uterus is firm and diffusely tender, with ongoing vaginal bleeding. Cardiotocography is currently reassuring. After initial IV crystalloid, her blood pressure remains low and bleeding continues. What is the most appropriate next step in management?

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