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:

**Core Concept**
The clinical presentation suggests a case of placenta previa, a condition characterized by **painless vaginal bleeding** in the second or third trimester due to the placenta partially or totally covering the internal cervical os. This condition is a leading cause of antepartum hemorrhage.

**Why the Correct Answer is Right**
Given the patient's symptoms and examination findings, such as painless bleeding, a relaxed uterus, and an unengaged fetal head, the management should focus on stabilizing the patient and preparing for possible delivery, considering the gestational age and the risk of further bleeding.

**Why Each Wrong Option is Incorrect**
**Option A:** Incorrect as it may not be the immediate step without further assessment.
**Option B:** Incorrect as it does not directly address the potential need for urgent delivery or the management of the bleeding.
**Option C:** Incorrect because, although important, it does not specify the immediate action needed for a patient with suspected placenta previa.

**Clinical Pearl / High-Yield Fact**
In cases of suspected placenta previa, it is crucial to avoid digital vaginal examination due to the risk of provoking further bleeding. Ultrasound is the diagnostic tool of choice to confirm the diagnosis.

**Correct Answer:** D. Ultrasound to confirm the diagnosis and arrangement for immediate delivery if necessary, considering the gestational age and the well-being of the fetus.

✓ Correct Answer: A. Caesarean section