27. 24 years old Primigravida at 30 weeks presented with continuous pain in abdomen with vaginal bleeding, around 250ml.She smokes 20 cigarettes per day.She has repeated episodes of spotting in this pregnancy. During examination she is quiet and scared.
Bp-100/70mm of Hg
Bruises present over back and legs and, on her abdomen, as well
She has a black left eye
P/A- uterus, 30weeks, tense and hard
Speculum examination – os-2cm dilated dark brownish bleeding +
What is the most important cause of abruption you suspect in this woman ?