Placenta praevia usually occurs after 30 weeks gestation.
It presents with recurrent, painless vaginal bleeding. The initial bleed commonly ceases spontaneously. Its onset is usually unprovoked, although occasionally it may follow intercourse. The amount of blood lost is highly variable, ie, from a few spots to several pints. The blood is bright red.
On examination the uterus is usually very relaxed and the fetal parts are readily palpable. The presenting part is usually not engaged and may be deviated to one side.
DO NOT PERFORM A VAGINAL EXAMINATION as severe haemorrhage may be provoked by disturbing blood vessels lying across the os.
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