Physician Assistant Review Answers: 3rd trimester bleeding

1.  B is the correct answer

1. painful 3rd trimester bleeding is the hallmark of placental abruption
2. painless 3rd trimester bleeding is a red flag for placenta previa
3. painful 1st trimester bleeding could indicate a spontaneous abortion or an ectopic
4. painless 1st trimester bleeding may indicate a molar pregnancy, spontaneous abortion

2.  Placental abruption

3.  AMA, smoking, h/o c-section, multiparity, h/o D&C.  remember that placenta previa is when the placenta implants over the internal os.  Risk factors would include anything that would create scarring of the uterus forcing the implantation lower.  

4. B is correct

1. placenta previa is reliably diagnosed with U/S
2. placental abruption can not be diagnosed with U/S (though clinically getting one is probably a good idea)
3. U/S will be helpful in diagnosing a spontaneous abortion
4. ectopic is diagnosed with an U/S

5.  Degree of seperation, age of fetus, fetal distress, maternal distress