A pregnant patient with sudden onset of severe uterine pain and no vaginal bleeding should be assessed for which condition?

In the scenario presented, a pregnant patient experiencing sudden onset of severe uterine pain with no vaginal bleeding warrants assessment for abruptio placentae. This condition, characterized by the premature separation of the placenta from the uterine wall, can lead to severe abdominal or back pain and may or may not present with vaginal bleeding. The severity of the pain and the potential risk to both the mother and the fetus make it critical for healthcare providers to evaluate this possibility swiftly.

While bladder retention and fecal impaction could cause discomfort, they typically do not manifest as severe uterine pain in the context of pregnancy. Dystocia, or difficult labor, might also be a consideration, but it is more associated with labor progression issues rather than sudden, severe pains in early or mid-pregnancy without accompanying symptoms indicative of labor. Therefore, the most relevant and potentially dangerous condition to assess for in this situation is abruptio placentae, given the clinical presentation of acute uterine pain.