When should a vaginal exam be performed if placenta previa is suspected?

In the case of suspected placenta previa, performing a vaginal exam is contraindicated. The correct approach is to avoid any vaginal examinations because they can induce bleeding. Placenta previa occurs when the placenta is located low in the uterus and partially or completely covers the cervical opening, increasing the risk of hemorrhage, particularly if there is cervical manipulation.

If a vaginal exam is done, it could disrupt the placental attachment and lead to significant maternal and fetal complications, including severe bleeding that could jeopardize both the mother and the fetus's health. Therefore, the safest practice in suspected placenta previa is to avoid vaginal examinations entirely, confirming the diagnosis through imaging techniques like ultrasound instead. This allows for careful monitoring and management of the condition without increasing the risks associated with unnecessary physical examination.