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Placenta previa — MCCQE Part 1 MCQ

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HardBleeding in PregnancyPlacenta previaMCCQE Part 1

A 30-year-old woman at 29 weeks' gestation reports painless bright-red vaginal bleeding. The uterus is soft and non-tender, fetal heart rate is normal, and she is haemodynamically stable. Placental location has not been documented. What is the most appropriate investigation?

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Correct answer: A — Transabdominal then transvaginal ultrasound for placental location

Painless third-trimester bleeding with a soft uterus suggests placenta previa until proven otherwise; ultrasound, including transvaginal imaging when needed, is the appropriate investigation. Digital vaginal examination before excluding previa can provoke major haemorrhage. Beta-hCG does not help in a known viable pregnancy. CT and endometrial biopsy are inappropriate.

Reference: SOGC placenta previa guidance