North American Registry of Midwives (NARM) Practice Exam

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What is the cardinal sign of placenta previa?

Painful contractions
Painless bleeding that is usually sudden in onset
Fetal heart rate abnormalities
Severe abdominal pain

The correct answer is: Painless bleeding that is usually sudden in onset

The cardinal sign of placenta previa is characterized by painless bleeding that typically occurs suddenly. This condition arises when the placenta partially or completely covers the cervix, which can lead to bleeding as the pregnancy progresses, particularly in the later stages. In many cases, this bleeding does not come with the typical pain associated with other conditions, making it a distinctive feature of placenta previa. The absence of pain helps differentiate it from other potential causes of bleeding during pregnancy, such as placental abruption, where pain is usually present. Therefore, recognizing this painless bleeding is crucial for prompt diagnosis and management, as it can pose significant risks to both the mother and fetus if not appropriately addressed.