A patient at 34 weeks with a known placenta previa develops heavy vaginal bleeding. Her hemoglobin is 8.5 g/dL, pulse 110/min, BP 100/70 mmHg. Fetal heart rate is 145/min with moderate variability. The most appropriate next step is:

• A Artificial rupture of membranes
• B Induction of labor with oxytocin
• C Expectant management with corticosteroids and close observation
• D Emergency cesarean section ✓

Explanation

Heavy vaginal bleeding from placenta previa with maternal tachycardia requires emergency cesarean section regardless of gestational age. Vaginal delivery is contraindicated in placenta previa. Expectant management applies only when bleeding is minimal and the patient is stable.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.