A 30-year-old G2P1 at 32 weeks presents with mild vaginal spotting after intercourse. Speculum examination shows a friable cervix with a small ectropion and no active bleeding from the os. Ultrasound shows a posterior placenta, 4 cm from the internal os. Fetal heart rate is normal. What is the most likely cause of bleeding?
- A Placenta previa
- B Abruptio placentae
- C Cervical ectropion ✓
- D Vasa previa
Correct answer: C. Cervical ectropion
Explanation
Postcoital spotting with a visible friable ectropion on speculum and a normally located placenta points to cervical ectropion as the cause. Placenta previa is ruled out by the placental location 4 cm from the os. Abruptio presents with painful bleeding and uterine tenderness. Vasa previa causes painless bleeding with fetal distress at membrane rupture.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.