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Painless bright red bleeding in the third trimester
Obstetrics & Gynaecology · exam-style practice question with explanation
A woman at 33 weeks has painless, bright red vaginal bleeding. The uterus is soft and non-tender. Which examination must be avoided until the placenta is located?
- A. Abdominal palpation
- B. Digital vaginal examination
- C. Blood pressure measurement
- D. Fetal heart auscultation
Show the answer and explanation
Answer: B. Digital vaginal examination
Painless bright red bleeding with a soft uterus suggests placenta praevia. Do not perform a digital vaginal examination until ultrasound has located the placenta, because it can trigger massive bleeding. Painful bleeding with a hard, tender uterus suggests placental abruption instead.
Key point: Painless bleeding + soft uterus = praevia; no digital VE.
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