Placental Abruption vs. Preterm Labor vs. Placenta Previa

What type of vaginal bleeding is seen with Placental Abruption, Preterm Labor, and Placenta Previa?

• Placental Abruption: Dark red bleeding, may be concealed or visible

• Preterm Labor: Bright red, mucus-streaked bleeding

• Placenta Previa: Bright red, painless, recurrent bleeding

What type of pain is associated with each condition?

• Placental Abruption: Constant, sharp pain with uterine tenderness

• Preterm Labor: Intermittent pain with contractions

• Placenta Previa: No pain or mild discomfort; typically painless

How does uterine activity differ among the three?

• Placental Abruption: Frequent contractions, rigid abdomen

• Preterm Labor: Regular contractions, uterus soft between

• Placenta Previa: Normal tone, uterus soft

What are typical fetal status findings for each condition?

• Placental Abruption: Fetal distress (late decelerations, bradycardia)

• Preterm Labor: Fetal status usually reassuring, unless labor advances

• Placenta Previa: Fetal status usually reassuring unless bleeding becomes severe

What are the cervical findings for each?

• Placental Abruption: May not be present initially

• Preterm Labor: Cervical dilation and effacement occur

• Placenta Previa: No cervical change; placenta may obstruct cervix

What are the major risk factors for each condition?

• Placental Abruption: Trauma, hypertension, previous abruption

• Preterm Labor: Dehydration, multiple gestation, infection

• Placenta Previa: Prior C-section, uterine surgery, multiple gestation

What complications are associated with each?

• Placental Abruption: Maternal shock, DIC, fetal demise

• Preterm Labor: Preterm birth, neonatal complications (RDS, immaturity)

• Placenta Previa: Hemorrhage, preterm birth, placenta accreta risk

How are these conditions diagnosed?

• Placental Abruption: Clinical signs + ultrasound

• Preterm Labor: Clinical, confirmed with cervical exam + ultrasound

• Placenta Previa: Ultrasound (placenta location) — no vaginal exams!

What is the key management focus for each condition?

• Placental Abruption: Stabilize mother, monitor fetus, prepare for delivery if needed

• Preterm Labor: Delay labor if possible; give corticosteroids (Betamethasone) for fetal lung maturity

• Placenta Previa: Avoid vaginal exams, monitor bleeding, prepare for C-section if bleeding severe