A 30-year-old woman at 34 weeks has painless antepartum hemorrhage. Ultrasound shows a low-lying posterior placenta with the placental edge 1.5 cm from the internal os. She has stopped bleeding and is hemodynamically stable. The MOST appropriate management plan is:

• A Admission, betamethasone for lung maturity, and plan cesarean at 36–37 weeks ✓
• B Emergency cesarean section to prevent catastrophic hemorrhage
• C Cervical cerclage to prevent preterm delivery
• D Expectant management at home with pelvic rest until 38 weeks

Explanation

Marginal placenta previa (placental edge 1–2 cm from os) after a bleeding episode at 34 weeks requires inpatient management, corticosteroids (betamethasone) for fetal lung maturity, and planned cesarean at 36–37 weeks. Emergency cesarean is not required when bleeding has stopped and the patient is stable. Home management is unsafe given bleeding history. Placenta at 1.5 cm from os has significant risk of hemorrhage in labour and vaginal delivery is contraindicated; planned cesarean avoids this risk while allowing gestational maturation.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.