What condition presents with dark, painful vaginal bleeding and uterine tenderness?

The condition characterized by dark, painful vaginal bleeding and uterine tenderness is placenta abruption. In this scenario, the placenta prematurely separates from the uterine wall, leading to bleeding that can appear dark due to the age of the blood. The pain is typically significant because the separation causes irritation and contraction of the uterus. Uterine tenderness is a critical clinical finding that indicates the underlying issue associated with the abruption, as the uterus may respond to the separation with contraction and inflammation.

In contrast, placenta previa generally presents with bright red bleeding without pain and does not typically cause uterine tenderness, as the placenta remains attached and does not cause the same level of irritation. Eclampsia, which involves seizures and hypertension, does not primarily present with vaginal bleeding as a defining symptom. Vasa previa can lead to bleeding if the fetal vessels rupture, but this condition is less likely to cause the severe pain and tenderness associated with a placental abruption.