Placenta previa presents with which description?

• A. Sudden painful bleeding with a rigid uterus
• B. Painful bleeding with dark blood
• C. Painless vaginal bleeding with bright red blood
• D. Painless vaginal bleeding with bright red blood and a soft uterus

Answer: (D)

Placenta previa causes painless vaginal bleeding in the third trimester with a soft, non-tender uterus. This description fits because the placenta overlies the cervix and bleeds from placental vessels without causing uterine contractions or pain, so the uterus remains soft. In contrast, placental abruption presents with painful bleeding and a rigid, tender uterus due to uterine contractions and placental detachment. So the best match is painless bleeding with bright red blood and a soft uterus. Near term, this often requires planning for cesarean delivery and avoiding vaginal exams to prevent triggering more bleeding.