What is the colour of blood in placenta praevia?

Appeared in: UPPSC 2017

Explanation

In placenta previa, the placenta is implanted in the lower uterine segment, near the cervical opening.
When bleeding occurs due to placental separation, the blood is fresh and arterial.
Because the source of bleeding is close to the cervix, the blood escapes the vagina immediately.
This immediate escape means the blood does not have time to deoxygenate or form clots, so it appears bright red.

Option B: Brick red color suggests blood that is not fresh and has started to deoxygenate, which is not typical for the acute, arterial bleeding seen in placenta previa.
Option C: Brown or dark red blood indicates old blood that has been retained for some time, allowing for significant deoxygenation and breakdown of red blood cells.
Option D: This option is incorrect because 'Bright red' is the well-established and correct description for bleeding in placenta previa.

Clinical Relevance

Nursing practice connection: Knowing Clinical signs of placenta previa helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
A nurse's rapid assessment of the color and amount of vaginal bleeding, along with the presence or absence of pain, is critical in differentiating between placenta previa and abruptio placentae.
Bright red, painless bleeding strongly suggests placenta previa, prompting interventions like strict bed rest, avoidance of vaginal exams, and preparation for potential massive hemorrhage and emergency cesarean section.
This differentiation is vital for patient safety as the management protocols for these two obstetric emergencies are distinct.

How to Approach the Question

First, identify the key term in the question, which is 'placenta praevia'.
Recall the classic clinical presentation of placenta previa. The hallmark sign is painless vaginal bleeding in the second or third trimester.
Focus on the specific characteristic being asked: the 'colour of blood'.
Remember the pathophysiology: because the placenta is low-lying, any bleeding is fresh and exits quickly, appearing bright red.
Contrast this with abruptio placentae, where bleeding is often dark red due to being retained behind the placenta.
Select the option that matches the classic description of fresh, arterial bleeding.

Concept Tested & Keywords

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E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 19-27

Practise the full UPPSC 2017

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