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Placenta praevia — MCCQE Part 1 MCQ

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ModeratePregnancyPlacenta praeviaMCCQE Part 1

A 32-week pregnant woman has painless bright red vaginal bleeding, stable observations and a soft uterus; placental location is unknown. Which of the following is the most appropriate next step?

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Correct answer: D — Avoid digital vaginal examination and perform ultrasound placental localisation

Avoid digital vaginal examination and perform ultrasound placental localisation is the single best answer because the age, timing, examination findings and investigations in the vignette fit Placenta praevia better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to SOGC antepartum haemorrhage guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: SOGC antepartum haemorrhage guidance