The sign indicating placenta previa in a pregnant woman is?

Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2021

Explanation

The hallmark sign of placenta previa is painless, bright-red vaginal bleeding.
This bleeding typically occurs during the second or third trimester of pregnancy.
The bleeding results from the disruption of placental blood vessels as the lower uterine segment thins and dilates.
Unlike abruptio placentae, the uterus in placenta previa is usually soft, relaxed, and non-tender between bleeding episodes.

Option B: Dull low back pain is a common, non-specific complaint in pregnancy and can be related to musculoskeletal changes, labor, or urinary tract infections, but it is not a characteristic sign of placenta previa.
Option C: Uterine tetany, a hard, board-like, and persistently contracted uterus, is a classic sign of abruptio placentae, not placenta previa.
Option D: Epigastric pain is a key symptom of severe preeclampsia or HELLP syndrome, indicating liver capsule distention.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Clinical signs of placenta previa as background academic context rather than a clinical decision trigger.
Recognizing painless vaginal bleeding as a potential sign of placenta previa is critical for nurses to ensure patient safety by preventing contraindicated procedures like vaginal exams.
Immediate notification of the healthcare provider, initiation of fetal monitoring, and preparation for potential hemorrhage are key nursing actions.
A primary nursing responsibility is patient education about 'pelvic rest,' which means no vaginal intercourse, no douching, and no vaginal exams for the remainder of the pregnancy.

How to Approach the Question

First, identify the core concept of the question, which is recognizing the signs of placenta previa.
Recall the classic presentation of placenta previa. The key features are painless bleeding of bright-red blood.
Evaluate each option against this classic presentation.
Option A, 'Painless vaginal bleeding,' directly matches the hallmark sign.
Options B, C, and D are characteristic signs of other serious pregnancy complications (non-specific pain, abruptio placentae, and severe preeclampsia, respectively). Eliminate them.
Confirm that painless vaginal bleeding is the most specific and accurate sign for placenta previa among the choices.

Concept Tested & Keywords

Concept Tested: Clinical signs of placenta previa
Stem keywords: placenta previa, sign, pregnant woman
Lead-in keywords: BEST, MOST RELEVANT CLUE
Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.
Negative lead-in flag: false

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

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