A 32-year-old G3P1 woman at 31 weeks gestation presents to the emergency department with a history of recurrent, painless bright red vaginal bleeding over the past 24 hours, which has recently increased in volume. Her previous pregnancy was delivered via cesarean section due to a breech presentation. She denies any abdominal pain, contractions, or trauma. Fetal movements are reported to be consistent. On admission, her vital signs are: temperature 37.00C, blood pressure 110/70 mmHg, pulse 96/min, respirations 18/min, and oxygen saturation 98% on room air. Physical examination reveals a gravid uterus, soft and non-tender to palpation. A sterile speculum examination, performed cautiously, shows a closed cervical os with a moderate amount of fresh blood pooling in the vaginal vault. Transabdominal ultrasound performed in the ED is suggestive of the placenta covering the internal cervical os. What is the most likely diagnosis and the critical initial management step in this scenario?

A 28-year-old G3P2002 woman at 32 weeks and 3 days of gestation presents to the emergency department with a sudden onset of painless vaginal bleeding. She reports being at home when she felt a gush of fluid, followed immediately by significant blood loss. Her obstetric history is notable for a previous urgent cesarean section due for placenta previa. On arrival, her vitals are: temperature 37.0°C, blood pressure 110/65 mmHg, pulse 98/min, respirations 20/min, and oxygen saturation 97% on room air. Physical examination reveals gross blood in the vaginal os, and the fetal head is not palpable. Continuous fetal heart rate monitoring demonstrates severe, prolonged decelerations and persistent bradycardia. Intravenous access has been established, and fluids initiated. Considering the clinical presentation and past obstetric history, what is the most likely diagnosis and the immediate, critical management intervention required to prevent adverse maternal and fetal outcomes?

A 35-year-old G2P1001 female, with a history of one prior Caesarean section, presents to an outpatient women's health clinic complaining of intermittent, painless vaginal bleeding that began approximately 24 hours ago. She estimates her gestational age to be around 28 weeks, based on her last menstrual period, but has received sporadic prenatal care. She denies any uterine contractions, abdominal pain, or other symptoms. Her previous C-section was performed 5 years ago for failure to progress. She admits to occasional cigarette smoking but denies illicit drug use since discovering her pregnancy.On examination, her vital signs are stable: temperature 36.9°C, blood pressure 118/72 mmHg, pulse 78/min, respirations 16/min. She appears comfortable and her fundal height measures 28 cm. Abdominal palpation reveals a soft, non-tender uterus. A moderate amount of bright red blood is noted in the vaginal vault upon speculum examination; however, the cervical os is closed, and no active bleeding from the os is observed. External fetal monitoring shows a reassuring fetal heart tracing with good variability, accelerations, and no decelerations.Given her presentation, which of the following represents the most likely diagnosis and the immediate, appropriate management strategy?

A 32-year-old G4P2012 woman at 36 weeks 5 days of gestation, with a history of prior assisted reproductive technology (ART) and a low-lying placenta noted at an earlier ultrasound, presents to the labor and delivery unit experiencing sudden, painless vaginal bleeding that started approximately 45 minutes ago. Initially, it was light spotting, but has now progressed to a moderate gush of bright red blood. She denies abdominal pain, contractions, or any recent trauma. Her prenatal care has been sporadic. On admission, her vital signs are stable, but a stat fetal monitoring strip (refer to Figure A) shows persistent fetal bradycardia. Given her current presentation and the emergent fetal findings, what is the most likely diagnosis and the immediate, definitive management strategy?