In abruptio placentae, which sign is most concerning for maternal physiologic compromise?

In abruptio placentae, which sign is most concerning for maternal physiologic compromise?

• A. Normal uterus
• B. Increased uterine resting tone
• C. Decreased contractions
• D. No fetal monitoring changes

Answer: (B)

In abruptio placentae, maternal physiologic compromise becomes most evident when the uterus is hypertonic at rest. An increased resting tone signals uterine irritability and ongoing placental separation with concealed bleeding, which can rapidly worsen maternal bleeding and shock by reducing overall uteroplacental perfusion. A firm, tense uterus at rest is a red flag that the hemorrhage may be progressing despite what might appear as stable fetal monitoring. By contrast, a normal uterus suggests stability; decreased contractions are not typical for abruptio and don’t by themselves indicate maternal compromise, and no fetal monitoring changes don’t reliably reflect the mother’s hemodynamic status. The key danger cue is the tense, hyperactive-appearing uterus, which points to active bleeding and potential rapid deterioration.

In abruptio placentae, maternal physiologic compromise becomes most evident when the uterus is hypertonic at rest. An increased resting tone signals uterine irritability and ongoing placental separation with concealed bleeding, which can rapidly worsen maternal bleeding and shock by reducing overall uteroplacental perfusion. A firm, tense uterus at rest is a red flag that the hemorrhage may be progressing despite what might appear as stable fetal monitoring.

By contrast, a normal uterus suggests stability; decreased contractions are not typical for abruptio and don’t by themselves indicate maternal compromise, and no fetal monitoring changes don’t reliably reflect the mother’s hemodynamic status. The key danger cue is the tense, hyperactive-appearing uterus, which points to active bleeding and potential rapid deterioration.