Premature separation of the placenta from the uterine wall before delivery is?

Appeared in: JIPMER Pondicherry NO - 2022

Explanation

Abruptio placenta, also known as placental abruption, is the medical term for the premature separation of a normally implanted placenta from the uterine wall.
This condition typically occurs after the 20th week of gestation and before the fetus is delivered.
The separation is initiated by hemorrhage into the decidua basalis, which forms a hematoma that splits the decidua, detaching the placenta.
This process disrupts the flow of oxygen and nutrients to the fetus, posing a significant risk to both mother and baby.

Option B: Placenta previa refers to the abnormal implantation of the placenta in the lower uterine segment, covering or near the cervical os. The issue is the placenta's location, not its premature separation.
Option C: Fetal distress is a sign of fetal compromise (e.g., hypoxia) and is a potential consequence of placental abruption, not the definition of the separation itself.
Option D: Cord prolapse is an obstetric emergency where the umbilical cord descends ahead of the presenting part of the fetus, which is unrelated to the placenta detaching from the uterine wall.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Hemorrhagic Disorders in Pregnancy as background academic context rather than a clinical decision trigger.
Recognizing the signs of abruptio placenta is critical for nurses as it is a life-threatening emergency. The classic triad is vaginal bleeding, uterine tenderness/pain, and uterine contractions.
Immediate nursing actions include establishing large-bore IV access, continuous fetal monitoring, and preparing for potential emergency delivery to prevent maternal hemorrhage and fetal demise.
A key assessment is palpating the uterus. A board-like, rigid, and tender uterus is a hallmark sign of a significant abruption, often with concealed hemorrhage.

How to Approach the Question

First, break down the question stem: "Premature separation of the placenta from the uterine wall before delivery."
This is a direct definition-based question. Your task is to identify the correct medical term for this specific event.
Evaluate each option against the definition.
Option A, 'Abruptio placenta', is the direct medical term for premature placental separation.
Option B, 'Placenta previa', describes the location of implantation, not separation.
Option C, 'Fetal distress', is a consequence of placental problems, not the problem itself.

Concept Tested & Keywords

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E6 Obstetrics Williams p. 63-85

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