A 24-year-old pregnant woman in her third trimester involved in a motor vehicle crash presents with intense lower abdominal pain and vaginal bleeding with a steady flow but no crowning. What is the suspected condition?

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Painful vaginal bleeding in the third trimester after trauma points to placental abruption, when the placenta detaches from the uterus. This detachment causes intense abdominal pain and ongoing bleeding, and the uterus is often tender or firm. Placenta previa usually presents with painless bleeding and a soft, non-tender uterus, not associated with trauma-induced pain. Ectopic pregnancy is a concern earlier in pregnancy, not in late third trimester, and miscarriage typically occurs before the third trimester. So the pattern here—trauma with painful bleeding and a tender abdomen in late pregnancy—best fits placental abruption. In the field, treat as an obstetric emergency: ensure airway and oxygen, establish IV access, monitor mother (and fetal status if feasible), and transport rapidly to a facility with obstetric care, avoiding vaginal exams if placental abruption is suspected.