A 28-year-old woman, gravida 1, para 0, aborta 0, presents to your clinic for a...

A low-lying placenta identified at the routine 20-week anatomy scan is common and often resolves as the pregnancy progresses. As the uterus enlarges, the lower uterine segment stretches and the placenta typically “migrates” upward relative to the internal cervical os. Therefore, immediate intervention is not indicated in an asymptomatic patient. The appropriate next step is repeat ultrasonography in the third trimester, commonly around 32 weeks’ gestation, to reassess placental location. Early recommendation of cesarean delivery is premature because many low-lying placentas identified at mid-pregnancy resolve before term. Routine activity restriction or stopping work is not indicated in the absence of bleeding. Acupuncture has no evidence-based role in placental positioning. While placenta previa is associated with painless third-trimester bleeding, at 20 weeks most cases are transient findings. MCCQE objectives emphasize appropriate follow-up of incidental ultrasound findings, avoidance of unnecessary interventions, patient reassurance, and evidence-based monitoring in obstetric care.