The most prevalent clinical manifestation of abruptio placentae (as opposed to placenta previa) is:
A.
Intense abdominal pain.
B.
Uterine activity.
C.
Bleeding
D.
Cramping.
The Correct answer and Explanation is:
The correct answer is A. Intense abdominal pain.
Explanation:
Abruptio placentae, also known as placental abruption, is a serious obstetric condition where the placenta prematurely detaches from the uterine wall before the delivery of the baby. This condition can lead to severe complications for both the mother and the fetus, including hemorrhage, fetal distress, and preterm birth. Abruptio placentae is a medical emergency requiring immediate intervention.
The most prevalent clinical manifestation of abruptio placentae is intense abdominal pain. This pain is usually sudden and severe, often described as sharp or stabbing. The pain is a result of the separation of the placenta from the uterine wall, which leads to bleeding and the formation of a retroplacental clot. This clot further irritates the uterine muscle, leading to continuous, painful contractions.
Uterine activity (B) is also increased in abruptio placentae, but this is usually secondary to the intense abdominal pain. The uterus may feel firm or board-like upon palpation due to the concealed hemorrhage and the associated uterine contractions. While increased uterine activity is a notable sign, it is not as prominent as the intense pain.
Bleeding (C) is another critical symptom, but the nature of the bleeding distinguishes abruptio placentae from placenta previa. In abruptio placentae, bleeding can be either external or concealed. In many cases, the blood remains trapped behind the placenta, leading to minimal external bleeding, but significant internal blood loss and pain. In contrast, placenta previa typically presents with painless, bright red vaginal bleeding without associated pain.
Cramping (D) is a common symptom in many obstetric conditions, but it is not the hallmark of abruptio placentae. Cramping is typically less severe and less continuous than the intense pain observed in abruptio placentae.
In summary, while abruptio placentae can present with various symptoms, the most prevalent and distinguishing clinical manifestation is intense abdominal pain. This pain, combined with uterine rigidity and possible bleeding, helps differentiate abruptio placentae from other conditions like placenta previa, where painless bleeding is more common.