In total placenta previa, which finding requires immediate reporting to the healthcare provider?

• A. Variable fetal heart rate.
• B. Heart rate of 100 beats per minute.
• C. Onset of uterine contractions.
• D. Burning on urination.

Answer: (C)

In placenta previa, the placenta sits low in the uterus near or over the cervical opening, so any event that could trigger placental separation or heavy vaginal bleeding is a urgent signal. The onset of uterine contractions is especially important to report right away because contractions can provoke or worsen bleeding in this condition and indicate that labor may be starting. That rapid change in the dynamic around the placenta previa means the care team needs to monitor the bleeding, assess the fetus, and plan for safe delivery, often by cesarean, rather than attempting vaginal birth.

Other findings might warrant attention, but they’re not as directly tied to the immediate management of placenta previa. A change in fetal heart rate can indicate distress and requires evaluation, and a markedly low fetal rate is certainly concerning, but the specific scenario that most immediately escalates risk in placenta previa is the start of contractions. Burning on urination isn’t related to placenta previa and wouldn’t be the urgent signal in this context.