NREMT Emergency Medical Technician (EMT) Cognitive ExamMedical EmergenciesMedium
A 28-year-old female, 32 weeks pregnant, reports sudden onset of painless, bright red vaginal bleeding. She denies abdominal pain or trauma. Her vital signs are BP 100/70 mmHg, HR 98 bpm, RR 18 bpm. What is the MOST likely cause of her bleeding?
- AEctopic pregnancy.
- BThreatened abortion.
- CPlacenta previa.
- DAbruptio placentae.
Show answer & explanationAnswer & explanation
Correct answer: C. Placenta previa.
The patient's presentation of painless, bright red vaginal bleeding in the third trimester of pregnancy is the classic sign of placenta previa, where the placenta covers the cervix. This is a life-threatening condition for both mother and fetus, requiring immediate medical attention.
Why the other options are wrong
- A. Ectopic pregnancy occurs early in pregnancy and presents with unilateral abdominal pain and usually dark vaginal spotting, not bright red painless bleeding in the third trimester.
- B. Threatened abortion occurs in the first 20 weeks of pregnancy and involves vaginal bleeding, often with cramping, but not typically painless bright red bleeding in the third trimester.
- D. Abruptio placentae typically presents with painful vaginal bleeding, often dark red, and abdominal rigidity.
Placenta Previa
Placenta previa is a condition where the placenta partially or completely covers the cervix, leading to painless, bright red vaginal bleeding, typically in the second or third trimester of pregnancy.
- Painless vaginal bleeding is the hallmark symptom.
- Bleeding is usually bright red and can be heavy.
- Occurs in late pregnancy (after 20 weeks).
- Avoid vaginal exams, as they can worsen bleeding.
Memory trick: Painless, Bright Red, Pregnant: Placenta Previa's the dread!