Obstetrics & Gynaecology · Antepartum and Postpartum Hemorrhage

A woman at 36 weeks with known placenta previa develops heavy vaginal bleeding. Emergency cesarean section is performed. After delivery of the baby, the placenta is left in situ and the uterus is closed. This approach is appropriate in which situation?

  • A Placenta accreta with hemodynamic stability and desire to preserve fertility
  • B Placenta percreta with bladder invasion
  • C Placenta accreta with hemodynamic instability
  • D Placenta previa without accreta
Correct answer: A. Placenta accreta with hemodynamic stability and desire to preserve fertility

Explanation

Conservative management (leaving placenta in situ) is considered in hemodynamically stable patients with placenta accreta who desire fertility preservation, with close follow-up. In hemodynamic instability or percreta with bladder invasion, hysterectomy is indicated. In placenta previa without accreta, the placenta separates normally and is delivered.

Reference: High Risk Pregnancy: Management Options, 5th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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