A lady with 37 weeks pregnancy, presented with bleeding per vagina. Investigation shows severe degree of placenta pre. The treatment is
**Core Concept**
Placenta previa is a condition where the placenta partially or completely covers the internal cervical os. This can lead to severe bleeding during pregnancy, making it a high-risk condition that requires prompt management.
**Why the Correct Answer is Right**
In cases of severe placenta previa, the primary goal is to prevent maternal hemorrhage and ensure a safe delivery. The treatment of choice is usually cesarean delivery (C-section), as it minimizes the risk of further bleeding and allows for a controlled environment for delivery. This is because the cervix is not yet fully dilated, and vaginal delivery can exacerbate the bleeding.
**Why Each Wrong Option is Incorrect**
**Option A:** Expectant management is not suitable for severe placenta previa, as it increases the risk of maternal hemorrhage and fetal compromise.
**Option B:** Induction of labor is contraindicated in severe placenta previa, as it can lead to severe bleeding and compromise the mother's and fetus's health.
**Option C:** Medical management with uterotonic agents may help reduce bleeding, but it is not a definitive treatment for severe placenta previa and does not address the underlying issue.
**Clinical Pearl / High-Yield Fact**
In cases of suspected placenta previa, it is essential to perform a transvaginal ultrasound to confirm the diagnosis and assess the extent of the placenta's involvement.
**Correct Answer:** C. Cesarean delivery is the treatment of choice for severe placenta previa.