If Mrs Leela has Placenta Previa, what will be the most prominent symptom among these?

Appeared in: MP CHO-2018

Explanation

Placenta Previa occurs when the placenta implants in the lower uterine segment, partially or completely covering the cervix.
The hallmark symptom is sudden, painless, bright-red vaginal bleeding, typically occurring after 20 weeks of gestation.
The bleeding results from the tearing of placental attachments as the lower uterine segment thins and the cervix begins to dilate, a process that is not inherently painful.

Option B: An abdomen that is 'like a board' (board-like rigidity) is the classic sign of a severe Abruptio Placentae, not Placenta Previa.
Option C: Pain is the primary feature that makes this option incorrect for Placenta Previa. The bleeding in Placenta Previa is characteristically painless.
Option D: Dull pain is not a characteristic symptom of Placenta Previa. The condition is defined by its painless nature.

Clinical Relevance

Nursing practice connection: Knowing Clinical manifestations of Placenta Previa helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Recognizing painless, bright-red bleeding as the cardinal sign of Placenta Previa is critical for prompt diagnosis via ultrasound and appropriate management.
A crucial nursing safety intervention is to never perform a digital vaginal examination on a pregnant woman with antepartum bleeding until Placenta Previa has been ruled out. This action can cause catastrophic hemorrhage.
What if? If the patient presented with painful, dark-red bleeding and a rigid, tender abdomen, the primary suspicion would shift to Abruptio Placentae. This would necessitate immediate assessment for maternal shock and fetal distress, often leading to an emergency cesarean delivery.

How to Approach the Question

First, identify the key diagnosis in the question stem, which is 'Placenta Previa'.
Recall the classic or hallmark symptom associated with this specific obstetric condition.
Evaluate each option to see which one matches the textbook presentation of Placenta Previa.
The most characteristic symptom of Placenta Previa is painless, bright-red vaginal bleeding.
Eliminate the other options by identifying them as symptoms of other conditions. A 'board-like abdomen' and 'pain' are classic signs of Abruptio Placentae, the main differential diagnosis.

Concept Tested & Keywords

QpYPM8WHiJ-9hHZbnOQmuj

E6 Obstetrics Williams pp. 71-95, 68-93

Practise the full MP CHO-2018

Attempt every question from this paper in a timed mock, then review the full solution for each one.