A lady with 38 weeks of pregnancy is admitted in view of first episode of painless bout of bleeding yesterday. O/E: Hb 10.5g%, BP 124/78 mmHg, uterus relaxed, and head is un-engaged and floating. FHS regular. Next line of management is:
Correct Answer: Caesarean section
Description: This is a case of placenta pre (painless bleeding, relaxed uterus, and floating head all point to placenta pre). Since the lady is already 38 weeks, there is no need for conservative management since maturity is already achieved. The best management is a Cesarean section here If the same patient presented at less than 36 weeks, the answer would be wait and watch. If there was fetal distress at any stage after 28 weeks with APH, the answer would be LSCS If there was maternal hemodynamic instability, the answer would be blood and IV fluids, followed by emergency LSCS.
Category:
Gynaecology & Obstetrics
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