A nurse is caring for a client who is at 36 weeks of gestation and suspected of having placenta previa.
Which of the following symptoms would support this diagnosis?
A.
Abdominal pain accompanied by minimal red vaginal bleeding.
B.
Intermittent abdominal pain following the passage of bloody mucus.
C.
Increasing abdominal pain with a nonrelaxed uterus.
D.
Painless red vaginal bleeding.
The Correct Answer and Explanation is:
The correct answer is:
D. Painless red vaginal bleeding.
Explanation:
Placenta previa is a condition where the placenta is abnormally positioned in the lower part of the uterus, either partially or completely covering the cervical os (the opening of the cervix). This condition can lead to several characteristic symptoms, particularly related to bleeding patterns.
Painless Red Vaginal Bleeding:
One of the hallmark symptoms of placenta previa is painless red vaginal bleeding. This bleeding typically occurs without accompanying abdominal pain and usually starts around the 20th week of gestation or later, as the uterus expands and the placenta’s position causes it to separate from the uterine wall. The bleeding is often bright red and may be intermittent. The absence of pain is a distinguishing feature from other conditions like placental abruption, where abdominal pain is more common.
Other Options Explained:
- A. Abdominal pain accompanied by minimal red vaginal bleeding: This symptom is more indicative of placental abruption rather than placenta previa. Placental abruption involves the premature separation of the placenta from the uterine wall, which can cause abdominal pain and bleeding. Placenta previa, on the other hand, is typically associated with painless bleeding.
- B. Intermittent abdominal pain following the passage of bloody mucus: This symptom suggests a possible mucous plug discharge or labor onset, but it is not characteristic of placenta previa. In placenta previa, bleeding is typically painless, and abdominal pain is not a common symptom unless there is an associated complication.
- C. Increasing abdominal pain with a nonrelaxed uterus: This description is more consistent with placental abruption or other complications. In placenta previa, abdominal pain is not a primary symptom; the bleeding is usually the main concern.
In summary, painless red vaginal bleeding is the symptom that best supports the diagnosis of placenta previa. This condition requires careful monitoring and management to ensure the health and safety of both the mother and the fetus, and often necessitates a planned delivery, usually via cesarean section, to avoid complications during labor.