This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Miscellaneous (Gynae), Subject name: Gynaecology & Obstetrics
Painless bleeding in 3rd trimester is a feature of 
Select and explain. 
A. Placenta praevia, B. Abruptio placenta, C. Vesicular mole, D. None
A: Placenta praevia
Answer: A: Placenta praevia 
Explanation: Ans) a (Placenta praevia) Ref Williams 22nd editionCauses of APHa) Placental (70%)- Placenta previa (35%) - Abruption (35%)b) Extra placental (5%)- Cervical carcinoma - Carcinoma cervix - Varicose vein - Local traumac) Unexplained (25%) Stall Worthy sign- Low lying (post type)Dangerous placenta previa - TypeAt 20wks - 30 % placenta low lyingAt term - 2 % placenta low lyingSymptoms- Painless bleeding -Warning haemorrhagesO/E- Malpresentation - Floating head - FHS present - Stall Worthy's signInvestigation-USG - (TVS) - Colour Doppler -MRIClinical complication - Double setup examinationIndication for CS in PP(a) Severe degree of PP (Type IIB & above)(b) Lesser degree where amniotomy fails to stop bleeding(c) Associated factors eg contracted pelvis