In placenta previa, which action should be avoided to minimize bleeding risk?

In placenta previa, which action should be avoided to minimize bleeding risk?

• A. Digital vaginal examination
• B. Ultrasound imaging
• C. Bed rest and monitoring
• D. Fetal heart rate monitoring

Answer: (A)

When placenta previa is present, the placenta lies near or over the cervical os, and the lower uterine segment becomes highly vascular. Digital vaginal examination involves inserting a finger into the vagina and manipulating the cervix, which can disrupt placental tissue and trigger heavy, sometimes uncontrollable bleeding. Because of this direct risk, the examination should be avoided until placental location is clearly known by imaging. Ultrasound imaging is the safe, noninvasive way to determine placental placement and guide management, so it’s used rather than any internal vaginal examination. Monitoring of the fetus, including fetal heart rate assessment, is important for detecting distress, and bed rest and monitoring may be employed in some cases to observe symptoms, but they do not address the bleeding risk caused by vaginal manipulation. The key is to avoid any vaginal examination that could disturb the placenta.

When placenta previa is present, the placenta lies near or over the cervical os, and the lower uterine segment becomes highly vascular. Digital vaginal examination involves inserting a finger into the vagina and manipulating the cervix, which can disrupt placental tissue and trigger heavy, sometimes uncontrollable bleeding. Because of this direct risk, the examination should be avoided until placental location is clearly known by imaging.

Ultrasound imaging is the safe, noninvasive way to determine placental placement and guide management, so it’s used rather than any internal vaginal examination. Monitoring of the fetus, including fetal heart rate assessment, is important for detecting distress, and bed rest and monitoring may be employed in some cases to observe symptoms, but they do not address the bleeding risk caused by vaginal manipulation. The key is to avoid any vaginal examination that could disturb the placenta.