Question

A primigravida at 22 weeks of gestation presents to you with profuse vaginal bleeding. Her blood pressure and glucose levels are within normal limits. Placental implantation at which of the following sites can cause this? 

• A. Internal OS
• B. Fallopian tube
• C. Ovarian
• D. Abdominal

Answer 1

The Correct Option is A

The condition described in this scenario is suggestive of placenta previa, which is characterized by placental implantation near or over the internal cervical os. During pregnancy, when the placenta implants low in the uterus over or near the internal os, it can cause significant vaginal bleeding, especially in the second half of pregnancy. This bleeding occurs because as the cervix and lower part of the uterus begin to stretch and thin in preparation for labor, the placental attachment over the os disrupts, leading to bleeding.

Explanation of Options:

Internal OS	This leads to conditions like placenta previa, causing bleeding in the second half of pregnancy, as described in the scenario. This is the correct answer.
Fallopian tube	Implantation here leads to ectopic pregnancy, typically presenting with symptoms much earlier and not at 22 weeks gestation.
Ovarian	Ovarian implantation is another form of ectopic pregnancy and is generally non-viable and typically detected early in pregnancy.
Abdominal	Abdominal pregnancies are rare and involve implantation outside the uterus, leading to atypical symptoms and complications, unrelated to the symptoms described.

Therefore, the correct answer that matches the clinical presentation of profuse vaginal bleeding at 22 weeks gestation is Internal OS.