In placental abruption with signs of potential cerebral hypoperfusion, which finding indicates reduced cerebral perfusion?

• A. Restlessness
• B. Fever
• C. Tachypnea only
• D. Nausea

Answer: (A)

When cerebral blood flow falls, the brain’s oxygen delivery drops and the earliest noticeable effect is on mental status. Restlessness reflects this subtle, early brain underperfusion, as neurons struggle without enough oxygen and nutrients. In placental abruption, significant blood loss can lower circulating volume and perfusion pressure, so the patient may become agitated or irritable as the brain’s perfusion decreases. Fever points to infection or inflammation rather than perfusion, tachypnea alone is a respiratory or metabolic response rather than a direct sign of brain perfusion, and nausea is nonspecific. Restlessness is the clearest cue that cerebral perfusion is being compromised.