Placenta previa commonly presents with which symptom?

Placenta previa commonly presents with which symptom?

• A. Painless vaginal bleeding in the second or third trimester
• B. Severe abdominal cramps with rigid uterus
• C. Painful bleeding with uterine tenderness
• D. No bleeding and a normal ultrasound

Answer: (A)

Painless vaginal bleeding in the second or third trimester is the hallmark sign of placenta previa. This happens because the placenta implants near or over the cervical os, and as the cervix or placenta interacts during pregnancy, bleeding can occur without provoking pain or contractions. This presentation helps distinguish previa from conditions like placental abruption, which causes painful bleeding accompanied by a tender, firm uterus. In previa, the uterus is usually non-tender and there are no contractions. Understanding the location of insertion also explains why vaginal exams are approached with caution and ultrasound confirmation is used to plan delivery, often by cesarean if the placenta remains over the os.

Painless vaginal bleeding in the second or third trimester is the hallmark sign of placenta previa. This happens because the placenta implants near or over the cervical os, and as the cervix or placenta interacts during pregnancy, bleeding can occur without provoking pain or contractions.

This presentation helps distinguish previa from conditions like placental abruption, which causes painful bleeding accompanied by a tender, firm uterus. In previa, the uterus is usually non-tender and there are no contractions. Understanding the location of insertion also explains why vaginal exams are approached with caution and ultrasound confirmation is used to plan delivery, often by cesarean if the placenta remains over the os.