hey greetings guys mark boswell of basel emergency medical coming to you from the boswell pad um this is where the magic happens where i write all those test questions and do all the home publishing etc um so a couple days ago i put up a question about placental abruption versus placenta previa i noticed not everybody was getting consistently the right answer there was still a little confusion on that so i want to share with you something that was taught to me a few years ago that's helped me every time i've seen this question on the exam between abruption versus um previa and i've seen it on every exam i've taken it always comes up at least once it's kind of like the the inferior in my question they'll show up to the organophosphates question that's one of the common ones they like to ask about so let's look at the words here placenta previa a little card for you here if you notice there is a p for placenta and a p for previa we're going to take that p and substitute p for painless p for privates okay privates remind you it's a gyn issue or an ob issue painless not always painless of zero but it's always a much lower grade pain than the abruption uh in the test question you'll see descriptors like the ladies complaining of cramping aching a dull pressure like sensation if she rates it on a 10 scale beyond at least the lower half of the 10 scale like a 5 or less it will not be a significantly painful event okay so placenta previa p for placenta p for previa change that to p for painless to remind you it's either zero pain or a low grade pain and p for privates contrasting that with our placental abruption there is a p and placenta there's an a interruption we're going to change that now it's going to be a for always p for painful so what we're doing is we're contrasting the descriptor of how much pain this mother's having with her obstetrical urgency going on here now this condition in all exam questions will be described with a pain level that's significant severe um high grade uh above five on the pain scale some dramatic difference and that's how you tell the difference between these two while one may be described as painless the abruption will always be very very painful and even if they give you a previa and they say she's having some pain you'll always be a much lower grade pain than the abruption okay so abruption is always a higher grade pain placenta previa is always a lower grade pain of course there's other things that tell the difference between the two also previa tends to happen more in the second trimester abruption more in the third trimester abruption is more consistent with the mechanism of some type of injury uh blunt abdominal trauma on the gravity uterus previa does not have to have injury normally for it to happen which one is an emergency which one is a true life or death emergency concerning the risk to the fetus as well as to the mother hey that's easy placental abruption has that letter a i want to remember this it's always an emergency always an emergency previa it's important but it's between the two the abruption is the emergency because the fetal circulation is being compromised and there's some internal bleeding that's going on that may not be visible with the abruption so some of that blood's already being pulled out of the mother's circulation all right that's your free test taking tip for the date for the day today y'all personal abruption versus placenta previa remember the p and the p and the p and the a one is lower grade pain one is higher previa abruption one is always an emergency abruption a for always all right good luck hope that helps you guys like i said it's on the exam often i've seen it on every version i've taken the last several years all right email me facebook me however you need to keep following us good luck to you let me know how it goes and comment on the video okay thanks take care be safe