A case of 32 weeks of pregnancy with cornual placenta with breech presentation, treatment of choice is :
**Core Concept**
A cornual placenta, also known as a placenta accreta spectrum disorder, is a condition where the placenta partially or completely covers the uterine cornua (the outer edges of the uterus). In a case of cornual placenta at 32 weeks of pregnancy with a breech presentation, the primary concern is the risk of placental abruption, postpartum hemorrhage, and severe maternal morbidity. Therefore, a conservative approach is often preferred to minimize the risk of complications.
**Why the Correct Answer is Right**
In cases of cornual placenta, the risk of placental abruption and postpartum hemorrhage is significantly increased. A cesarean section (C-section) is often associated with a higher risk of these complications, especially if the placenta is adherent to the uterine wall. External cephalic version (ECV) is not typically recommended in cases of cornual placenta due to the increased risk of placental abruption. Vaginal breech delivery is also not advised due to the potential for severe maternal morbidity. Therefore, a wait-and-watch approach is often preferred to allow for careful monitoring and planning of the delivery.
**Why Each Wrong Option is Incorrect**
**Option B:** External cephalic version (ECV) is not recommended in cases of cornual placenta due to the increased risk of placental abruption, which can lead to severe maternal morbidity.
**Option C:** Elective C-section carries a higher risk of placental abruption and postpartum hemorrhage in cases of cornual placenta, making it a less desirable option.
**Option D:** Vaginal breech delivery is not advised due to the potential for severe maternal morbidity and the risk of placental abruption.
**Clinical Pearl / High-Yield Fact**
In cases of cornual placenta, it is essential to carefully monitor the mother and fetus for signs of placental abruption and to plan a delivery strategy that minimizes the risk of complications.
**✓ Correct Answer: A. Wait & Watch**