Ultrasound showing<unk> .<unk>  is suspected when a pregnant mother has sudden localized abdominal pain with or without bleeding. The fundus may be monitored because a rising fundus can indicate bleeding. An ultrasound may be used to rule out<unk> praevia but is not diagnostic for<unk> . The diagnosis is one of exclusion, meaning other possible sources of vaginal bleeding or abdominal pain have to be ruled out in order to diagnose<unk> . Of note, use of magnetic resonance imaging has been found to be highly sensitive in depicting<unk> , and may be considered if no ultrasound evidence of<unk>  is present, especially if the diagnosis of<unk>  would change management. Classification Based on severity: * Class 0: Asymptomatic. Diagnosis is made retrospectively by finding an organized blood clot or a depressed area on a delivered<unk>  * Class 1: Mild and represents approximately 48% of all cases. Characteristics include the following: * No vaginal bleeding to mild vaginal bleeding * Slightly tender uterus * Normal maternal blood pressure and heart rate * No coagulopathy * No fetal distress * Class 2: Moderate and represents approximately 27% of all cases. Characteristics include the following: * No vaginal bleeding to moderate vaginal bleeding * Moderate-to-severe uterine tenderness with possible tetanic contractions * Maternal tachycardia with orthostatic changes in blood pressure and heart rate * Fetal distress * Hypofibrinogenemia (i.e., 50–250 mg/dL) * Class 3: Severe and represents approximately 24% of all cases. Characteristics include the following: * No vaginal bleeding to heavy vaginal bleeding * Very painful tetanic uterus * Maternal shock * Hypofibrinogenemia (i.e., <150 mg/dL) * Coagulopathy * Fetal death
Placental abruption
Chorioamnionitis
Uterine rupture
Placenta praevia
Bloody show
Toxic abortion
Umbilical cord prolapse
Septic abortion