A lady with 37 weeks pregnancy, presented with bleeding per vagina. Investigation shows severe degree of placenta previa. The treatement is:
**Core Concept**
Placenta previa is a condition in pregnancy where the placenta partially or completely covers the internal cervical os, leading to vaginal bleeding. The severity of the condition is determined by the extent of placental coverage and the presence of bleeding.
**Why the Correct Answer is Right**
In severe placenta previa, the risk of maternal and fetal hemorrhage is high, and immediate delivery is often required to prevent severe maternal morbidity. A cesarean section is the preferred mode of delivery, as it minimizes the risk of further bleeding and allows for control of the placental bed.
**Why Each Wrong Option is Incorrect**
* **Option A:** Medical management with bed rest and observation is not appropriate for severe placenta previa, as it does not address the underlying cause of bleeding.
* **Option B:** Induction of labor is contraindicated in severe placenta previa, as it can lead to further bleeding and is associated with a high risk of maternal and fetal complications.
* **Option C:** Vaginal delivery is not a safe option for severe placenta previa, as it can result in severe bleeding and is associated with a high risk of maternal and fetal morbidity.
**Clinical Pearl / High-Yield Fact**
In cases of severe placenta previa, the American College of Obstetricians and Gynecologists (ACOG) recommends delivery by cesarean section, ideally at a tertiary care center with a team experienced in managing placenta previa.
**Correct Answer:** C.