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Central placenta praevia with heavy bleeding per vaginum

Author: RxPG, Posted on Tuesday, September 21 @ 00:00:00 IST by RxPG  

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Obstetrics

A primigravida at 37 week of gestation reported to labour room with central placenta praevia with heavy bleeding per vaginum. The fetal heart rate was normal at the time of examination. The best management option for her is:
1. Expectant management.
2. Caesarean section.
3. Induction and vaginal delivery.
4. Induction and forceps delivery.


Answer
2. Caesarean section.

Reference
Test book of Obstetrics 4th Edition D.C.Dutta 265 to 267
Mudaliar Ninth Edition Page 247

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Discussion
Central Placenta Praevia You have to do LSCS sooner or later
The patient is bleeding PV
Gestation is 37 weeks
FH Normal - The child is alive You have to save the child

Explanation
1. Expectant management can be considered if the baby is not matured ie Duration of Pregnancy LESS THAN 37 weeks.
2. Caesarean section is the ideal option.
3. Induction and vaginal delivery is not possible in Central Placenta Praevia.
4. Induction and forceps delivery is not possible in Central Placenta Praevia.

Comments
This question is asked in almost all UPSC Exams !!

Tips
Placenta Praevia and Accidental haemorrhages are being asked in MCQ exams for years !!! and will be asked in future also. Refer to the Criteria for expectant management in Dutta


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