A 32-year-old G3P2 at 30 weeks of gestation presents with sudden onset painless bright red vaginal bleeding. She has no uterine contractions and the fetal heart rate is normal. Ultrasound shows an anterior low-lying placenta completely covering the internal os. Which of the following is the MOST appropriate immediate management?
- A Emergency cesarean section immediately
- B Digital cervical examination to assess for labor
- C Admission, monitoring, and plan elective cesarean at 36–37 weeks if stable ✓
- D Oxytocin augmentation to expedite delivery
Correct answer: C. Admission, monitoring, and plan elective cesarean at 36–37 weeks if stable
Explanation
This patient has placenta previa (complete) presenting with painless antepartum hemorrhage. If bleeding is not life-threatening and fetal status is reassuring, expectant management with hospitalization and corticosteroid administration between 24–34 weeks is appropriate. Elective cesarean is planned at 36–37 weeks. Digital vaginal examination is absolutely contraindicated in placenta previa as it can precipitate catastrophic hemorrhage.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.