All are true about placenta previa EXCEPT:
ANSWER: (C) Increased uterine toneREF: Current Diagnosis & Treatment Obstetrics & Gynecology, 10th edition Chapter 20 Placenta Previa Essentials of DiagnosisSpotting during first and second trimesters.Sudden, painless, profuse bleeding (bright red, clotted blood) in third trimester.Initial cramping in 10% of cases. Abruptio placentaPlacenta previaHistory* Frequent association of preeclampsia or hypertension from any cause* A single attack of vaginal bleeding, which usually continues until delivery* Abdominal pain* No association with preeclampsia* Repeated warning hemorrhages often occurring over a period of weeks* Usually no abdominal painAbdominal Examination* Local uterine tenderness, hypertonic "woody" uterus in a concealed abruption* patient usually in labor* Presenting part often engaged* Presenting part maybe difficult to palpate* Fetal heart sounds often absent* Normal uterine tone and usually no tenderness* Patient rarely in labor* Presenting part above brim, malpresentation usually found* Fetal parts usually palpable* Fetal heart sounds usually presentAncillary aids* placenta demonstrated in upper uterine segment by ultrasound* Placenta demonstrated in lower uterine segment by ultrasoundVaginal examination* Double set-up reveals no placenta within 5 cm of internal os* Double set-up reveals placenta implanted in the lower uterine segment
Bright red blood loss
Painless vaginal bleeding
Increased uterine tone
Malpresentations usually found
Placenta Previa