Regarding placenta praevia, which classical symptom complex distinguishes it from placental abruption?

• A Painful, dark red vaginal bleeding with uterine hypertonicity
• B Vaginal bleeding associated with preterm labor and membrane rupture
• C Painless bright red vaginal bleeding with a soft non-tender uterus ✓
• D Uterine pain with a woody-hard uterus and fetal distress

Explanation

Placenta praevia classically presents with painless, sudden, bright red vaginal bleeding (due to tearing of placental sinuses as the lower uterine segment forms), occurring in the late second or third trimester, with a soft, non-tender uterus. The presenting part is high and malpresentations are common. This contrasts with placental abruption, which presents with painful dark venous bleeding, uterine hypertonicity/rigidity ('woody uterus'), and fetal distress due to retroplacental hematoma formation.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.