What is the term for the abnormal separation of the placenta from the uterine wall prior to birth?

• A. Abruptio placentae
• B. Ectopic pregnancy
• C. Preeclampsia
• D. Eclampsia

Answer: (A)

The concept tested is premature detachment of the placenta from the uterine wall, which is called abruptio placentae (placental abruption). This occurs when the placenta separates before birth, leading to vaginal bleeding and a risk of fetal distress because the baby may lose its blood supply and oxygen. It’s a distinct condition from placenta previa, where bleeding happens because the placenta sits low over the cervix, typically with painless bleeding. It’s also different from ectopic pregnancy, where the embryo implants outside the uterus, and from preeclampsia/eclampsia, which are hypertensive disorders of pregnancy that can cause headaches, high blood pressure, protein in the urine, and seizures, not placental detachment.

Abruptio placentae is most concerning in the second or third trimester and is associated with factors like maternal hypertension, trauma, smoking, cocaine use, or a history of previous abruption. Diagnosis is often clinical, though ultrasound can help rule out other causes; the bleeding can be visible or concealed within the uterus. Management depends on how stable the mother and fetus are and how far along the pregnancy is, with severe cases potentially requiring rapid delivery and sometimes causing coagulation problems for the mother.