A woman in her second trimester presents with painless vaginal bleeding. Ultrasound shows the placenta completely covering the internal os. She is haemodynamically stable. Which examination is ABSOLUTELY CONTRAINDICATED?
- A Abdominal palpation
- B Digital vaginal examination ✓
- C Transabdominal ultrasound
- D Transvaginal ultrasound by a trained sonographer
Correct answer: B. Digital vaginal examination
Explanation
Digital vaginal examination is absolutely contraindicated in confirmed complete placenta praevia as it can precipitate catastrophic haemorrhage by disrupting the placenta overlying the os. Abdominal palpation and transabdominal ultrasound are safe. Transvaginal ultrasound with a trained operator is actually the most accurate method for placenta praevia assessment and is safe when performed carefully.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.