A 32-year-old woman who is 36 weeks pregnant complains of sudden severe abdominal pain and vaginal bleeding. What should you suspect?

The presentation of sudden severe abdominal pain along with vaginal bleeding in a woman who is in her third trimester of pregnancy raises significant concern for placental abruption, which is when the placenta detaches from the wall of the uterus before delivery. This condition can lead to serious complications for both the mother and the baby, including preterm birth, fetal distress, or even stillbirth.

In cases of placental abruption, the sudden onset of abdominal pain is typically associated with bleeding due to the separation of the placental tissue from the uterine wall. The pain may be localized or diffuse and is often accompanied by uterine contractions. Additionally, the amount of vaginal bleeding can vary, which further underlines the urgency of the situation.

The other options suggest scenarios that are either less likely or would typically not present with the same acute symptoms. For instance, the scenario where the umbilical cord is wrapped around the baby’s neck generally does not result in abdominal pain and bleeding but may lead to fetal distress or complications during delivery. An implantation over the cervical opening (placenta previa) is characterized by painless bleeding rather than sudden pain, and while the rupture of the amniotic sac can occur due to excessive fetal movement, it does not typically cause severe abdominal