Risk factor for abruptio placentae are all except-
**Core Concept**
Abruptio placentae, also known as placental abruption, is a serious pregnancy complication characterized by the premature separation of the placenta from the uterus. This condition can lead to fetal distress, maternal hemorrhage, and even maternal and fetal mortality. Identifying risk factors is crucial for early detection and management.
**Why the Correct Answer is Right**
Abruptio placentae is associated with various risk factors, including:
* **Hypertension**: Chronic hypertension and preeclampsia increase the risk of abruptio placentae due to the increased uteroplacental resistance and potential placental infarction.
* **Trauma**: Physical trauma to the abdomen, such as a motor vehicle accident or a fall, can cause abruptio placentae by disrupting the placental attachment.
* **Smoking**: Smoking during pregnancy is a known risk factor for abruptio placentae, possibly due to the reduction of placental blood flow and the development of placental infarction.
* **Advanced maternal age**: Women over 35 years old are at an increased risk of abruptio placentae, possibly due to the presence of underlying medical conditions that increase the risk of placental abruption.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because while **obesity** is a risk factor for various pregnancy complications, it is not a direct risk factor for abruptio placentae.
**Option B:** This option is incorrect because **previous cesarean section** is not a significant risk factor for abruptio placentae; however, it may increase the risk of other complications, such as uterine rupture.
**Option C:** This option is incorrect because **multiple gestations** (twins, triplets, etc.) may increase the risk of various pregnancy complications, but they are not a direct risk factor for abruptio placentae.
**Clinical Pearl / High-Yield Fact**
Abruptio placentae often presents with sudden, severe abdominal pain, vaginal bleeding, and fetal distress. Prompt recognition and management are critical to prevent maternal and fetal morbidity and mortality.
**Correct Answer:** D.