Which assessment finding is most consistent with placenta previa?

• A. Painless, bright red vaginal bleeding
• B. Severe abdominal pain with a rigid uterus
• C. Uterine tenderness with contractions
• D. Dark red bleeding with clots

Answer: (A)

Placenta previa shows up as painless vaginal bleeding in the third trimester because the placenta is implanted near or over the cervical os, and bleeding can occur with minimal or no uterine activity. The uterus usually remains soft and non-tender, so there isn’t the abdominal pain or rigid uterus you’d expect with other bleeding disorders. That contrast helps distinguish it from placental abruption, which presents with painful bleeding and a tender or rigid abdomen due to uterine irritability and contractions, and from labor, where contractions and progressive cervical changes accompany the bleeding.

So the key idea is that painless, bright red vaginal bleeding late in pregnancy points to placenta previa, with management focused on confirming placental location by ultrasound, avoiding vaginal exams to prevent provoking more bleeding, and coordinating delivery (often by cesarean) if bleeding recurs or the placenta remains low-lying.