Termination of pregnancy in placenta previa is indicated in a) Active bleedingb) Active labourc) Gestational age > 34 weeks with live fetusd) Fetal malformatione) Unstable lie
**Core Concept**
Placenta previa is a pregnancy complication characterized by the placenta partially or completely covering the internal cervical os. Management of this condition requires careful consideration of the risks and benefits of termination of pregnancy.
**Why the Correct Answer is Right**
Active bleeding is a life-threatening complication of placenta previa, often necessitating immediate termination of pregnancy to prevent maternal hemorrhage and shock. In such cases, the risk of fetal loss is weighed against the risk of maternal mortality. The other options are not indications for termination of pregnancy in placenta previa. Option B (Active labour) is actually a contraindication for delivery by cesarean section in placenta previa, as it increases the risk of severe maternal bleeding. Options C (Gestational age > 34 weeks with live fetus), D (Fetal malformation), and E (Unstable lie) are not directly related to the management of placenta previa.
**Why Each Wrong Option is Incorrect**
* **Option B:** Active labour in placenta previa increases the risk of severe maternal bleeding due to the increased uterine tone and distension.
* **Option C:** While a gestational age of > 34 weeks is generally considered viable, termination of pregnancy is not indicated solely by this criterion in placenta previa.
* **Option D:** Fetal malformation is not a direct indication for termination of pregnancy in placenta previa.
* **Option E:** Unstable lie is not a direct indication for termination of pregnancy in placenta previa.
**Clinical Pearl / High-Yield Fact**
In placenta previa, the key to management is to identify the type of placenta previa (central, marginal, or low-lying) and assess the severity of bleeding. In cases of active bleeding, termination of pregnancy may be necessary to prevent maternal hemorrhage and shock.
**Correct Answer: A. Active bleeding**