This page is dedicated to organizing various examples of standardized exam questions whose answer is placenta previa. While this may seem a odd practice, it is useful to see multiple examples of how placenta previa will be characterized on standardized exams (namely the boards and the shelf exams). This page is not meant to be used as a tradition question bank (as all of the answers will be the same), however seeing the classic “test” characterization for a disease is quite valuable.
Question # 1
A 30 year old woman, G3P2, comes to the emergency department because of a sudden-onset of heavy vaginal bleeding. She has had inconsistent prenatal care, and explains that she is about 8 months pregnant. She currently has no uterine contractions, and denies any feeling of pain. There is no abdominal trauma, and she denies having any recent intercourse. Five years ago she underwent a lower transverse cesarean delivery. She smokes a pack of cigarettes a day, and does not take any medications. Her physical examination shows a large amount of clot in the vaginal canal, as well as ongoing bright red bleeding from the cervix. Her fundal height is 34 cm, and her uterus is not tender to palpation. Fetal heart monitoring shows a baseline fetal heart rate of 150/min, moderate variability, accelerations, no decelerations, and the absence of uterine contractions. What is the most likely diagnosis in this patient?
Explanation: third trimester bleeding + painless uterus = placenta previa
Question # 2
A 32 year old female G4P2A1 woman is admitted at 31 weeks gestation because of sudden onset of painless vaginal bleeding. She explains that she has soaked four perineal pads and finally now the bleeding has stopped. Her pulse in 90 bpm and BP is 120/70 mm Hg. A CBC and coagulation panel are collected and are pending. An ultrasound is immediately ordered. What might it show?
Explanation: third trimester + painless bleeding = placenta previa
Page Updated: 10.10.2016