Obstetrics and Gynaecologycommon
A 34-year-old woman, gravida 3 para 2, presents at 34 weeks gestation with two hours of constant severe abdominal pain and a small amount of dark red vaginal bleeding. She smokes 15 cigarettes daily and takes labetalol for high blood pressure diagnosed before pregnancy. On examination her pulse is 110/min and blood pressure 150/95 mmHg; the uterus is rigid and markedly tender, and fetal parts are difficult to palpate. The membranes are intact and cardiotocography shows a fetal heart rate of 168/min with reduced variability. Which one of the following is the most likely diagnosis?