A 26-year-old primigravida at 32 weeks gestation presents with moderate vaginal bleeding and mild uterine contractions. On examination, the uterus is soft and non-tender. Fetal heart rate is 140 bpm with normal variability. Ultrasound shows a posterior placenta, no retroplacental clot, and a closed cervix. What is the most appropriate initial management?
- A Expectant management with corticosteroids for fetal lung maturity ✓
- B Induction of labor with oxytocin
- C Immediate cesarean delivery
- D Artificial rupture of membranes
Correct answer: A. Expectant management with corticosteroids for fetal lung maturity
Explanation
This patient has a stable placenta previa or minor antepartum hemorrhage at 32 weeks with a viable fetus and no evidence of fetal compromise. Expectant management is indicated, including administration of betamethasone for fetal lung maturity. Delivery is indicated only if bleeding is life-threatening, fetal compromise occurs, or gestation reaches 36 to 37 weeks. Immediate delivery at 32 weeks in a stable patient would expose the neonate to prematurity complications unnecessarily.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.