Florida State Paramedic Practice Exam 2025 - Free Paramedic Practice Questions and Study Guide

The presentation of tearing pain, a tender rigid uterus, and bright red bleeding in a patient with a history of multiple pregnancies, including previous cesarean sections, is highly indicative of placental abruption. This condition occurs when the placenta separates prematurely from the uterine wall, which can lead to significant maternal and fetal morbidity.

The tearing pain aligns with the abrupt onset of pain commonly reported with abruption, and the rigid uterus suggests the presence of underlying hemorrhage that can cause uterine hypertonicity. Additionally, bright red bleeding is characteristic of an abruption, where blood from the separated placenta mixes with amniotic fluid and may present as vaginal bleeding.

Patient history is also critical; in women with a prior cesarean section, there are additional risks associated with uterine scar tissue, which can contribute to complications such as abruption. The urgency of this condition necessitates immediate medical response to optimize outcomes for both the mother and the fetus.