A woman at 32 weeks’ gestation comes to the emergency department with painless vaginal bleeding

A woman at 32 weeks’ gestation comes to the emergency department with painless vaginal bleeding. Her temperature is 37.1° C (98.8° F), pulse is 76/min, and blood pressure is 126/90 mm Hg. The fetal heart rate is 155/ min. She has no other symptoms. Urinalysis shows no blood cells or bacteria and a normally elevated β-hCG level. Which of the following diagnoses should the emergency department physician consider before performing a gynecologic examination?

  • (A) Abruptio placentae
  • (B) Eclampsia
  • © Hydatidiform mole
  • (D) Placenta previa
  • (E) Preeclampsia

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