A 26-year-old primigravida at 34 weeks gestation presents with sudden-onset, painless, bright red vaginal bleeding of moderate quantity. There is no uterine tenderness on examination. Her blood pressure is 110/70 mmHg. Fetal heart rate is 152 bpm. The MOST likely diagnosis is:
- A Abruptio placentae
- B Vasa praevia
- C Placenta praevia ✓
- D Uterine rupture
Correct answer: C. Placenta praevia
Explanation
Placenta praevia classically presents with painless, bright red antepartum haemorrhage, typically in the third trimester, in a non-tender uterus with no fetal distress initially. Abruptio placentae typically presents with painful dark bleeding and uterine tenderness/rigidity. Vasa praevia presents with fetal distress and bleeding at membrane rupture. Uterine rupture causes severe abdominal pain and fetal bradycardia.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.