Which obstetric complication involves the placenta detaching from the uterine wall before birth?

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

Answer: (D)

Placental abruption is the premature separation of the placenta from the uterine wall before birth. When this happens, blood can accumulate behind the placenta, causing painful vaginal bleeding and a firm, tender uterus. The detachment disrupts blood flow to the fetus, which can lead to fetal distress, and the mother can lose a significant amount of blood, risking shock. That combination—new onset abdominal pain with bleeding and a tense uterus in a pregnant patient—points to an obstetric emergency due to placental separation before delivery.

Ectopic pregnancy involves implantation outside the uterus, so the placenta doesn’t detach from the uterine wall in the way described. Preeclampsia and eclampsia are hypertensive disorders of pregnancy with symptoms like high blood pressure, headaches, edema, and sometimes seizures, not placental separation.