A 32-Year-Old Woman, Gravida 2 Para 1, at 30 Weeks

A 32-year-old woman, gravida 2 para 1, at 30 weeks gestation comes to the emergency department 30 minutes after a gush of clear fluid from the vagina.  The patient initially thought she was leaking urine but leakage continued after voiding.  She reports occasional contractions but no fever, chills, or vaginal bleeding.  Fetal movements are normal.  This pregnancy has been complicated by iron deficiency anemia requiring a prenatal vitamin and iron supplementation.  She has no chronic medical conditions and has had no surgeries.  The patient's previous pregnancy ended in an uncomplicated term vaginal delivery.  She does not use tobacco, alcohol, or illicit drugs.  The patient owns a bakery, where she works 12-14 hours a day and often lifts heavy objects.  Temperature is 36.7 C (98.1 F) , blood pressure is 98/60 mm Hg, and pulse is 78/min.  BMI is 28 kg/m².  The fetal heart rate is 150/min with moderate variability and no decelerations.  Tocometry reveals no contractions.  The abdomen is nontender.  Sterile speculum examination reveals a large pool of clear fluid that is nitrazine positive, and the cervix appears to be 1 cm dilated.  Urinalysis shows trace protein.  Transabdominal ultrasound reveals a fetus in transverse lie and an amniotic fluid index of 5 cm.  Which of the following is the most likely complication of this patient's presentation?

A) Placenta accreta
B) Preeclampsia
C) Renal agenesis
D) Umbilical cord prolapse
E) Uterine rupture