Pre-Birth Hemorrhage is listed as indicating which placental conditions?

• A. Placenta previa and Abruptio placentae
• B. Placenta previa only
• C. Abruptio placentae only
• D. Placenta accreta and previa

Answer: (A)

Antepartum (pre-birth) hemorrhage refers to bleeding before delivery. In late pregnancy the two most common causes are placenta previa and placental abruption. Placenta previa occurs when the placenta implants low in the uterus, near or over the cervix. As the cervix dilates or labor begins, the placenta can bleed when stressed, producing often painless vaginal bleeding. Placental abruption is when the placental lining separates prematurely from the uterine wall, which can cause sudden, painful vaginal bleeding, sometimes with uterine tenderness and contractions. Because both conditions involve bleeding before birth, pre-birth hemorrhage is listed as indicating either placenta previa or abruptio placentae. Other placental issues, like placenta accreta, tend to cause heavy bleeding after delivery when the placenta fails to separate rather than bleeding before birth.