Snapshot A 29-year-old G2P1 female presents to labor and delivery triage with bleeding in the third trimester. Her first pregnancy was a cesarean delivery delivered at 37 weeks. She describes her bleeding as painless spotting without abdominal pain. An urgent transabdominal ultrasound is performed, showing a viable fetus and normal amniotic fluid. A transvaginal ultrasound is subsequently performed, and shows the placental edge located 1cm from the internal cervical os. Introduction Overview login to view 1 more bullet Epidemiology login to view 6 more bullets Associated conditions login to view 2 more bullets Presentation Most common presentation is asymptomatic finding on routine ultrasound at 16-20 weeks of gestation Symptoms login to view 4 more bullets Physical exam login to view 7 more bullets Imaging Ultrasonography login to view 6 more bullets Studies Rh compatability test Complete blood cell (CBC) count Prothrombin time (PT) and activated partial thromboplastin time (aPTT) Blood type and cross Levels of fibrin split products (FSP) and fibrinogen Differential Abruptio placentae login to view 3 more bullets Placenta accreta login to view 3 more bullets Vasa previa login to view 3 more bullets Treatment Medical login to view 9 more bullets Surgical login to view 6 more bullets Complications Congenital malformations login to view 1 more bullet Fetal malpresentation Vasa previa login to view 2 more bullets Postpartum hemorrhage