A 26-year-old primigravida at 32 weeks presents with Grade II placental abruption with confirmed fetal demise. She is hemodynamically stable, coagulation profile is normal, and cervix is unfavorable. What is the MOST appropriate management?

• A Immediate cesarean section
• B Induction of labor with misoprostol or oxytocin ✓
• C Expectant management with a wait for spontaneous labor
• D Administer betamethasone and deliver at 34 weeks

Explanation

In abruption with fetal demise, vaginal delivery is preferred unless there is severe hemorrhage or maternal instability. With an unfavorable cervix, induction with misoprostol (preferred in preterm with unfavorable cervix) or oxytocin is appropriate. Cesarean is avoided unless maternal status deteriorates. Expectant management risks DIC.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.