PLE-4402

A 40-year-old woman, G6P5 (5005), was brought to the ER due to epistaxis, abdominal pain, and minimal vaginal bleeding. Her blood pressure was 200/110, pulse rate was 120 per minute, and respiratory rate was 20 per minute. Her last menstrual period was on July 31, 2014. She had irregular prenatal care at a lying-in clinic. On physical examination, her abdomen was rigid and her uterus was tender. The fundal height was 34cm and the fetal head was in the left occiput anterior position. The fetal heart rate was 100 beats per minute as detected by doppler. Upon speculum examination, there was minimal bleeding from the cervix. On internal examination, the cervix was long, 1 cm dilated, and the fetal head was floating. The patient had ++ leg edema and ++ deep tendon reflexes. Ultrasound showed retroplacental blood clots. What is the likely diagnosis?