Abruptio placenta is associated with:

IGNOU PB Bsc Entrance-2022

Obstetrics & Gynaecology

Easy

Appeared in: IGNOU PB Bsc Entrance-2022

Explanation

Abruptio placentae is the premature separation of the placenta from the uterine wall before delivery.
Toxemia of pregnancy is an older term for hypertensive disorders like preeclampsia and eclampsia.
Hypertension is the most frequent condition associated with placental abruption, with a relative risk of 2.1 to 4.0 for preeclampsia.
Maternal hypertension causes vascular damage in the placental bed, leading to hemorrhage and separation.
This process compromises fetal oxygenation and can lead to significant maternal hemorrhage.

Option B: While twin pregnancy (multifetal gestation) is a risk factor for abruption, particularly due to rapid uterine decompression after the first twin's birth, it is not considered the most common association compared to hypertensive disorders.
Option C: Maternal cardiac disease does not directly cause placental separation. It primarily affects the mother's ability to cope with the cardiovascular changes of pregnancy.
Option D: Multiparity (having multiple previous pregnancies) is a recognized but less significant risk factor for abruptio placentae compared to hypertension. Its relative risk is lower (1.3-2.3).

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Risk factors for Abruptio Placentae as background academic context rather than a clinical decision trigger.
Recognizing the link between hypertension and abruption is critical for nurses. It emphasizes the importance of vigilant blood pressure monitoring throughout pregnancy, especially in women with pre-existing hypertension or those who develop gestational hypertension.
Abruptio placentae is an obstetric emergency. Nurses must be prepared for rapid response, including initiating large-bore IV access, administering oxygen, continuous fetal monitoring, and preparing the patient for an emergency C-section to save both mother and baby.
What if? If a pregnant patient with chronic hypertension presented with sudden, severe abdominal pain but no visible vaginal bleeding, the nurse should have a high index of suspicion for a concealed placental abruption and notify the provider immediately. The absence of bleeding does not rule out a life-threatening abruption.

How to Approach the Question

First, identify the core concept of the question, which is identifying the risk factors for 'Abruptio placenta'.
Recall the definition of abruptio placentae: premature separation of the placenta.
Analyze each option based on your knowledge of obstetric complications.
Consider 'Toxemia of pregnancy' (hypertensive disorders). Remember that high blood pressure damages blood vessels, including those supplying the placenta, making separation more likely.
Evaluate 'Twin pregnancy'. While a risk, think about the mechanism (uterine overdistension/decompression) and compare its prevalence as a cause to hypertension.
Assess 'Cardiac disease'. This affects the mother's heart function but doesn't directly cause the placenta to detach.

Concept Tested & Keywords

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E6 Obstetrics Williams p. 65-88