Placenta Previa: The Daily PANCE Blueprint
A 28-year-old pregnant patient at 35 weeks gestation presents to the clinic with acute onset of painless vaginal bleeding. Which of the following is the most likely diagnosis?
A. Uterine rupture
B. Placenta previa
C. Disseminated intravascular coagulation
D. HELLP syndrome
E. Premature rupture of membranes
Answer and topic summary
The answer is B. Placenta previa
Placenta previa is defined by the presence of placental tissue that extends over the internal cervical os. The major risk factors include previous placenta previa, previous cesarean delivery, and multiple gestations. The classic presentation is a pregnant woman (beyond 20 weeks gestation) who presents with painless vaginal bleeding. Diagnosis is made via sonographic identification of the echogenic homogenous placental tissue extending over the internal cervical os on a 2nd or 3rd-trimester imaging study. TVUS is preferred. Remember digital vaginal exam is a contraindication because palpation of the placenta can cause severe bleeding. Management depends on the gestational age and clinical symptoms/signs of the mother/fetus.
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Smarty PANCE Content Blueprint Review:
Covered under ⇒ PANCE Blueprint Reproductive System ⇒ ⇒
Also covered as part of the Women's Health EOR and Emergency Medicine EOR topic lists
