A G3P2 woman at 32 weeks presents with painless, bright red vaginal bleeding. Ultrasound confirms placenta previa. She is hemodynamically stable with a fetal heart rate of 148 bpm. What is the most appropriate immediate management?
- A Emergency cesarean section
- B Hospital admission, corticosteroids, and expectant management ✓
- C Digital examination to assess cervical os
- D Tocolysis with nifedipine and discharge home
Correct answer: B. Hospital admission, corticosteroids, and expectant management
Explanation
Hemodynamically stable placenta previa presenting before 34 weeks with a viable fetus is managed expectantly with hospital admission, corticosteroids for fetal lung maturity (at 32 weeks), and close monitoring. Digital vaginal examination is absolutely contraindicated in placenta previa as it risks catastrophic hemorrhage. Emergency cesarean is indicated only if the mother or fetus is compromised. Tocolysis alone with discharge is unsafe.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.