The signs of placenta previa are best described as which of the following?

• A. Painless third-trimester vaginal bleeding
• B. Board-like and tender abdomen
• C. Uterine hyperactivity and pain
• D. Fetal distress on monitoring

Answer: (A)

Placenta previa presents with painless vaginal bleeding in the third trimester because the placenta is covering or near the cervical os, so bleeding occurs with minimal or no uterine contractions and without abdominal pain. The uterus typically remains soft and non-tender.

This painless bleeding pattern is the hallmark, unlike the other scenarios which point to different obstetric emergencies. A board-like, tender abdomen suggests an acute abdomen such as placental abruption or uterine rupture, where the uterus becomes rigid and painful. Uterine hyperactivity with pain describes contractions or labor, not placenta previa. Fetal distress on monitoring can occur for various reasons and is not the defining sign of placenta previa.

If placenta previa is suspected, avoid digital vaginal exams and rely on ultrasound to confirm placental location, then plan delivery as appropriate, usually by cesarean if the previa persists near term.