Which obstetric condition requires avoidance of vaginal examinations?

• A. Placenta previa
• B. Ectopic pregnancy
• C. Placental abruption
• D. Molar pregnancy

Answer: (A)

The key idea is that vaginal examinations are avoided when placenta previa is present because the placenta is located low in the uterine segment, near or over the cervical os. Inserting a finger or performing a vaginal exam can disrupt the placental attachment and trigger life-threatening maternal bleeding. To assess placenta previa safely, clinicians rely on imaging—usually a transabdominal ultrasound—to determine placental position, rather than performing a digital or internal exam.

In placenta previa, the diagnostic approach and safety concerns drive why vaginal examination is avoided. Management focuses on careful monitoring and planning delivery, often by cesarean section, with efforts to minimize vaginal stimulation.

Other obstetric conditions listed do not have this same universal prohibition. For example, an initial pelvic assessment may be necessary in suspected ectopic pregnancy to evaluate symptoms and stability, and vaginal examination is not inherently contraindicated there. In placental abruption, decisions about examinations depend on clinical context, and the emphasis is on stabilization and delivery planning rather than a blanket avoidance of vaginal exams.