Which placental condition is associated with bright red bleeding?

• A. Placental previa (bright red bleeding)
• B. Placental abruptio (dark bleeding)
• C. Both conditions show bright red bleeding
• D. No placental bleeding

Answer: (A)

Bleeding patterns in late pregnancy help distinguish placental problems. Placenta previa occurs when the placenta implants near or over the cervical opening. Because the bleeding comes from placental vessels across the cervix, it’s typically bright red and usually painless. In contrast, placental abruption is the premature separation of the placenta and is typically painful, with a tender, rigid uterus, and the bleeding is often darker red. So bright red, painless bleeding most often points to placenta previa.

In the field, treat as an obstetric emergency: monitor the mother and fetus, provide oxygen, establish IV access, position the patient on her left side to improve venous return, and transport promptly. Avoid vaginal exams if previa is suspected. If abruption is suspected, expect pain and uterine tenderness and monitor for signs of fetal distress.