A 21 year old primigravida is admitted at 39 weeks gestation with painless antepartum hemorrhage. On examination uterus is soft non-tender and head engaged. The management for her would be:
Patient is presenting with painless vaginal bleeding and uterus is soft and nontender. These findings point towards the diagnosis of placenta previa (In abruptio-bleeding is accompanied by pain, uterus is tense, tender and rigid).
The gestational age of patient is 39 weeks i.e., fetal maturity is attained so pregnancy has to be terminated, either vaginally or by cesarean section.
Before termination of pregnancy, vaginal examination should be done in OT (keeping everything ready for cesarean section) to confirm the diagnosis of placenta previa.
Blood transfusion and sedatives
A speculum examination
Pelvic examination in OT
Tocolysis and sedatives