Which finding on admission would suggest placenta previa in a patient with vaginal bleeding?

Which finding on admission would suggest placenta previa in a patient with vaginal bleeding?

• A. Painless vaginal bleeding
• B. Abdominal pain with rigid uterus
• C. Painful vaginal bleeding
• D. Contractions with bleeding

Answer: (A)

Painless vaginal bleeding in late pregnancy points to placenta previa because the placenta is implanted low in the uterus near or over the cervical os. When bleeding occurs, it does so without causing uterine contractions or significant pain, so the uterus remains soft and non-tender. This painless bleeding pattern is a classic clue that the placental tissue is covering the cervix. In contrast, abruptio placentae presents with sudden, painful vaginal bleeding and a rigid, tender uterus due to placental separation and uterine contractions, which is why abdominal pain with a rigid uterus is more indicative of abruption. Painful vaginal bleeding is also more typical of abruption or labor with cervical dilation. Contractions with bleeding can occur in preterm labor or abruption, but they do not fit the usual presentation of placenta previa.

Painless vaginal bleeding in late pregnancy points to placenta previa because the placenta is implanted low in the uterus near or over the cervical os. When bleeding occurs, it does so without causing uterine contractions or significant pain, so the uterus remains soft and non-tender. This painless bleeding pattern is a classic clue that the placental tissue is covering the cervix.

In contrast, abruptio placentae presents with sudden, painful vaginal bleeding and a rigid, tender uterus due to placental separation and uterine contractions, which is why abdominal pain with a rigid uterus is more indicative of abruption. Painful vaginal bleeding is also more typical of abruption or labor with cervical dilation. Contractions with bleeding can occur in preterm labor or abruption, but they do not fit the usual presentation of placenta previa.