A lady with 38 weeks pregnancy and painless vaginal bleeding comes to casualty. On examination head is engaged and uterus is non tender and relaxed. The next line of treatment is :
**Core Concept**
The scenario presented is likely a case of placenta previa, a condition characterized by the placenta partially or completely covering the internal cervical os. This condition is a common cause of painless vaginal bleeding in the third trimester of pregnancy. The presence of a non-tender and relaxed uterus is consistent with this diagnosis.
**Why the Correct Answer is Right**
In the case of suspected placenta previa, the primary concern is to prevent further bleeding and ensure the mother's safety. The correct answer is likely to involve measures to stabilize the patient, including administering oxygen, ensuring fetal well-being, and preparing for potential operative delivery. This is because women with placenta previa are at risk of significant maternal and fetal morbidity if bleeding is not promptly controlled.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is likely incorrect because it may not directly address the risk of ongoing bleeding and potential maternal and fetal complications.
**Option B:** This option may be incorrect because it does not account for the potential need for immediate operative intervention to ensure the mother's safety.
**Option C:** This option is likely incorrect because it does not prioritize the immediate management of bleeding and potential complications.
**Clinical Pearl / High-Yield Fact**
It is essential to note that the diagnosis of placenta previa can only be confirmed by ultrasound examination, which should be performed in a stable patient. The absence of a tender uterus in this scenario is a key clinical clue, as it suggests that the bleeding is not due to labor or uterine distension.
**Correct Answer:** C. Immediate transfer to the operating theater for potential cesarean delivery.