Placental previa bleeding is typically described as which of the following?

• A. Painless vaginal bleeding.
• B. Painful vaginal bleeding with contractions.
• C. Bleeding accompanied by fever.
• D. Dark, clotted vaginal bleeding.

Answer: (A)

Placental previa presents with painless vaginal bleeding in the second or third trimester. When the placenta sits low in the uterus, covering or near the cervical os, the vessels can bleed as the cervix changes or as the uterus relaxes, but this bleeding occurs without uterine contractions or significant abdominal pain. That lack of pain is the hallmark that helps distinguish previa from other obstetric bleeds. The bleeding is often bright red and can occur suddenly, prompting evaluation with ultrasound to confirm placental location. In contrast, bleeding from placental abruption tends to be painful and accompanied by uterine contractions or tenderness, and fever or infection would point to other causes. Dark, clotted bleeding is not the typical presentation for previa.