A pregnant patient experiences painless bright red vaginal bleeding after intercourse. Which condition is most likely?

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Painless vaginal bleeding in late pregnancy, especially after intercourse, points to placenta previa. When the placenta implants near or over the cervical os, bleeding can occur with minimal pain because there isn’t the same uterine contraction or tenderness you’d expect with other conditions. The uterus often remains soft and non-tender.

In contrast, placental abruption typically presents with painful bleeding and a tender, rigid uterus due to ongoing contractions and uterine irritation. Ectopic pregnancy usually occurs earlier in pregnancy with abdominal pain and may have irregular bleeding. Uterine rupture causes sudden, severe abdominal pain with maternal instability and fetal distress, usually during labor.

So the most likely condition here is placenta previa. Confirmation is by ultrasound to locate the placenta, and management focuses on maternal-fetal monitoring and planning delivery if previa persists near term.