In a case of placenta previa totalis at 34 weeks with a single episode of painless bleeding that resolved spontaneously, maternal vitals stable and fetal CTG normal, what is the MOST appropriate management?
- A Expectant management with hospitalization, antenatal corticosteroids, avoidance of vaginal examination, and planned cesarean at 36–37 weeks ✓
- B Immediate emergency cesarean section
- C Oral tocolytics and discharge home with weekly outpatient review
- D Amniotomy and oxytocin to initiate labor
Correct answer: A. Expectant management with hospitalization, antenatal corticosteroids, avoidance of vaginal examination, and planned cesarean at 36–37 weeks
Explanation
For a single resolved bleed in placenta previa at 34 weeks with stable mother and fetus, the standard is expectant management in hospital: bed rest, avoidance of digital vaginal examination, antenatal corticosteroids for fetal lung maturity, cross-matched blood available, and planned cesarean at 36–37 weeks. Emergency cesarean is reserved for uncontrolled hemorrhage or fetal compromise. Tocolytics may be used transiently but are not the primary management; discharge home is inappropriate given recurrence risk.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.