UPUMS Nsg.Officer-2024
Obstetrics & Gynaecology
Easy
Premature separation of a normally implanted placenta during the second half of pregnancy usually with a haemorrhage is known as
Appeared in: UPUMS Nsg.Officer-2024
Explanation
- Abruptio placentae is the medical term for the premature separation of a placenta that was implanted in a normal position within the uterus.
- This condition typically occurs after 20 weeks of gestation and is a leading cause of antepartum hemorrhage (bleeding during pregnancy).
- The classic presentation includes vaginal bleeding (which can be dark red), sudden and severe abdominal or back pain, and uterine tenderness or rigidity.
- The bleeding can be 'revealed' (external) if it escapes through the cervix, or 'concealed' if it is trapped behind the placenta, which can be more dangerous as it may delay diagnosis.
Why Other Options Were Wrong
- Option A: Incompetent cervix involves painless dilation of the cervix, not premature separation of the placenta. It is a cause of second-trimester pregnancy loss but does not fit the description of placental separation and hemorrhage.
- Option B: Placenta previa involves a placenta that is abnormally implanted in the lower part of the uterus, covering or near the cervix. The key differentiator is that the placenta is abnormally implanted, and the bleeding is typically bright red and painless.
- Option D: Ectopic pregnancy is the implantation of the embryo outside the uterine cavity, usually in a fallopian tube. It is a complication of the first trimester, not the second half of pregnancy.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Antepartum Hemorrhage (APH) and Placental Disorders as background academic context rather than a clinical decision trigger.
- Abruptio placentae is a life-threatening obstetric emergency for both mother and fetus due to the risk of severe hemorrhage, maternal shock, disseminated intravascular coagulation (DIC), and fetal hypoxia or death.
- Nursing priorities include immediate assessment of maternal hemodynamic status (vital signs, urine output), quantification of blood loss, continuous fetal heart rate monitoring for signs of distress, and preparation for emergency delivery, often via cesarean section.
- What if? - If the question described painless, bright-red vaginal bleeding, the primary diagnosis would shift to Placenta Previa. The absence of pain is a critical clue that points away from abruption and towards previa.
How to Approach the Question
- First, break down the question into its key components: 1) premature separation, 2) normally implanted placenta, 3) second half of pregnancy, and 4) hemorrhage.
- Evaluate each option based on these key components.
- Recognize that 'Abruptio placentae' is the specific medical term that matches this exact definition.
- Rule out 'Placenta previa' because it involves an abnormally implanted placenta and typically painless bleeding.
- Eliminate 'Incompetent cervix' as it relates to cervical function, not placental separation.
- Exclude 'Ectopic pregnancy' because it occurs in the first trimester and involves implantation outside the uterus.
Concept Tested & Keywords
- Concept Tested: Antepartum Hemorrhage (APH) and Placental Disorders
- Stem keywords: premature separation, normally implanted placenta, second half of pregnancy, haemorrhage
- Lead-in keywords: known as
Question ID
QeN45IqUOZ3xqg7oFiwNJa
Reference Book
E6 Obstetrics Williams p. 63-85
Practise the full UPUMS Nsg.Officer-2024
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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