Why should vaginal examination be avoided in a patient with suspected placenta previa?

Why should vaginal examination be avoided in a patient with suspected placenta previa?

• A. Because digital examination could trigger a hemorrhage
• B. Because it would reveal previa
• C. Because it delays management
• D. Because it increases infection risk

Answer: (A)

When placenta previa is suspected, a vaginal examination is avoided because the placenta lies low in the uterus, often covering the internal cervical os. Digital manipulation at the cervix can disrupt the placental attachment and trigger sudden, heavy vaginal bleeding that endangers both mother and baby. This risk of catastrophic hemorrhage is the reason internal exams are avoided until the placental location is known by ultrasound. The safer approach is to confirm placental location with imaging and then plan management, typically including delivery by cesarean if previa persists. The other options don’t capture the main danger: a digital exam isn’t used to diagnose previa, it can precipitate bleeding, and the concern isn’t primarily about infection or delaying management.

When placenta previa is suspected, a vaginal examination is avoided because the placenta lies low in the uterus, often covering the internal cervical os. Digital manipulation at the cervix can disrupt the placental attachment and trigger sudden, heavy vaginal bleeding that endangers both mother and baby. This risk of catastrophic hemorrhage is the reason internal exams are avoided until the placental location is known by ultrasound. The safer approach is to confirm placental location with imaging and then plan management, typically including delivery by cesarean if previa persists. The other options don’t capture the main danger: a digital exam isn’t used to diagnose previa, it can precipitate bleeding, and the concern isn’t primarily about infection or delaying management.