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Placental Abruption vs. Previa

Aug 22, 2025

Overview

This lecture explains the key differences between placental abruption and placenta previa, focusing on pain level, associated risk, timing, and test-taking strategies.

Placenta Previa

  • Placenta previa involves the placenta covering part or all of the cervix.
  • Characterized by painless or low-grade pain vaginal bleeding in pregnancy.
  • Pain is usually mild, often rated 5 or less on a 10-point scale.
  • Occurs more commonly in the second trimester.
  • Not usually associated with trauma or injury.
  • Remember: "P" for Previa, "P" for Painless, and "P" for Privates (gynecological issue).

Placental Abruption

  • Placental abruption is the premature separation of the placenta from the uterus.
  • Presents with sudden, severe, high-grade abdominal pain and possible vaginal bleeding.
  • Pain is always significant, often rated above 5 on a 10-point scale.
  • More likely to occur in the third trimester.
  • Commonly linked to trauma (e.g., blunt abdominal injury).
  • Always considered a life-threatening emergency for both mother and fetus.
  • Remember: "A" for Abruption, "A" for Always painful and Always an emergency.

Exam Tips & Memory Aids

  • For exam questions, distinguish by pain severity: Previa = low or no pain, Abruption = high pain.
  • Placental abruption scenarios often describe trauma and significant pain.
  • Abruption is always a higher priority emergency due to compromised fetal circulation and internal bleeding.
  • The "P for Painless" and "A for Always" rules help recall key differences quickly.

Key Terms & Definitions

  • Placenta Previa — Placenta attaches low in the uterus, covering the cervix, causing painless bleeding.
  • Placental Abruption — Early separation of the placenta from the uterus, causing severe pain and potential hemorrhage.

Action Items / Next Steps

  • Review class materials on obstetric emergencies, focusing on placental abruption and previa.
  • Practice distinguishing scenarios in sample exam questions.
  • Contact instructor with questions or clarifications as needed.