Premature separation of the placenta from uterine wall after the 20th week of gestation is known as - - RUHS, Jaipur, PB B.Sc Nursing Entrance-2024

RUHS, Jaipur, PB B.Sc Nursing Entrance-2024

Obstetrics & Gynaecology

Easy

Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2024

Explanation

Abruptio placentae is the medical term for the premature separation of a normally implanted placenta from the uterine wall before delivery.
The condition is initiated by hemorrhage into the decidua basalis, which leads to the formation of a retroplacental hematoma that splits the decidua and separates the placenta.
It is a significant cause of antepartum hemorrhage (bleeding in late pregnancy) and poses severe risks to both the mother and the fetus.
Classic symptoms include painful vaginal bleeding (though bleeding can be concealed), uterine tenderness, and a tense or rigid uterus.

Option A: Placenta previa refers to the abnormal location of the placenta, where it is implanted in the lower uterine segment, covering or near the cervical opening. It does not involve premature separation from a normal implantation site.
Option C: Premature labor is defined by the onset of regular uterine contractions that lead to cervical changes (dilation and effacement) before 37 weeks of gestation. It is a disorder of uterine activity, not placental attachment.
Option D: A prolapsed cord is an obstetric emergency where the umbilical cord descends into the vagina ahead of the presenting part of the fetus after the membranes have ruptured. It is a complication of labor and delivery, not a placental separation issue.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Complications of pregnancy, specifically antepartum hemorrhage as background academic context rather than a clinical decision trigger.
Nurses must be able to rapidly differentiate between abruptio placentae and placenta previa, as they are both common causes of antepartum hemorrhage but require different management.
Key nursing assessments for suspected abruption include monitoring for painful vaginal bleeding (often dark red), uterine tenderness or rigidity (a board-like abdomen), signs of maternal shock (hypotension, tachycardia), and continuous fetal heart rate monitoring for signs of fetal distress.
Immediate interventions include establishing large-bore IV access, preparing for potential blood transfusion, and notifying the obstetric team for urgent evaluation and potential emergency delivery.

How to Approach the Question

First, identify the core concept in the question stem. The key phrase is "premature separation of the placenta from uterine wall."
This is a definitional question that requires recalling the correct medical terminology for a specific obstetric complication.
Analyze each option based on its definition.
Option A, Placenta previa, relates to the location of the placenta (low-lying), not its separation.
Option C, Premature labor, relates to early uterine contractions and cervical changes.
Option D, Prolapsed cord, relates to the position of the umbilical cord.

Concept Tested & Keywords

Concept Tested: Complications of pregnancy, specifically antepartum hemorrhage.
Stem keywords: premature separation, placenta, uterine wall, 20th week of gestation
Lead-in keywords: known as