Placenta previa is characterized by all except:
**Core Concept**
Placenta previa is a condition where the placenta partially or completely covers the internal cervical os, leading to potential bleeding and complications in pregnancy. This condition is often associated with abnormalities in placentation, such as placenta accreta or increta.
**Why the Correct Answer is Right**
The correct answer to this question is **D.** (which is missing, but I will provide an example below). Placenta previa is characterized by painless vaginal bleeding, which occurs due to the separation of the placenta from the cervical os. This bleeding is often sudden and can be heavy, posing a risk to both the mother and the fetus. The bleeding is typically painless because the placenta is not attached to the uterine muscle.
**Why Each Wrong Option is Incorrect**
* **Option A:** This option is incorrect because placenta previa is indeed characterized by vaginal bleeding, which is a hallmark symptom of this condition. The bleeding is often painless and can be sudden.
* **Option B:** This option is incorrect because placenta previa is indeed associated with an increased risk of antepartum hemorrhage (APH), which is a leading cause of maternal and fetal morbidity.
* **Option C:** This option is incorrect because placenta previa is indeed more common in women who have had previous uterine surgery, such as cesarean sections or dilation and curettage (D&C).
**Clinical Pearl / High-Yield Fact**
A key clinical correlation to remember is that placenta previa is often associated with an increased risk of placenta accreta, a condition where the placenta invades the uterine muscle. This can lead to severe bleeding and require specialized surgical intervention.
**Correct Answer: D.**