A 35-year-old G5P4 with prior three cesarean sections delivers by elective cesarean at 37 weeks for anterior placenta previa. Intraoperatively, the placenta is adherent and partially removed with difficulty. Bleeding is torrential from the placental bed. The most definitive management is:
- A B-Lynch compression suture
- B Uterine artery ligation
- C Emergency peripartum hysterectomy ✓
- D Uterine balloon tamponade
Correct answer: C. Emergency peripartum hysterectomy
Explanation
Placenta accreta spectrum with torrential hemorrhage unresponsive to conservative measures requires emergency peripartum hysterectomy as definitive management. Compression sutures and balloon tamponade are for atony, not adherent placenta. Uterine artery ligation is often insufficient for accreta bleeding.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.