Which condition involves the placenta detaching from the uterine wall prematurely, causing bleeding and potential fetal distress?

• A. Placenta previa
• B. Abruptio placentae
• C. Ectopic pregnancy
• D. Uterine rupture

Answer: (B)

Premature placental detachment from the uterine wall, known as placental abruption, is the scenario described. When the placenta pulls away before birth, the baby can lose part of its blood supply, leading to fetal distress. The bleeding can be vaginal, but it may also be concealed within the uterus, and the uterus is often tender and firm due to contractions. This combination—late-pregnancy bleeding with uterine tenderness and signs of fetal distress—best fits abruption.

Other conditions differ in how they present. Placenta previa causes painless vaginal bleeding late in pregnancy with a typically soft, non-tender uterus. Ectopic pregnancy involves implantation outside the uterus earlier in pregnancy and presents with pain and bleeding, but not placental detachment. Uterine rupture presents with sudden, severe pain and signs of fetal and maternal instability during labor, often with a scar on the uterus. Placental abruption requires urgent stabilization and delivery considerations due to the risk to both mother and fetus.