In accidental hemorrhage, TOC:
Ans. is c, i.e. Simultaneous emptying of uterus and blood transfusionRef: Williams Obs 23/e. p 767: Dutta Obs. 7/e, p 257, 258; COGDT 10/e, p 333The basic principle in the management of abruptio is termination of pregnancy along with correction of hypovolemia and restoration of blood loss."With massive external bleeding, intensive resuscitation with blood plus crystalloids and prompt delivery to control Hemorrhage are life saving for mother and hopefully fetus". --Williams Obs. 23/e, p 767This means option c is correct"Expectant management of suspected placental abruption is the exception, not the rule. This management pathway should be attempted only with careful observation of the patient and a clear clinical picture." (Option "d" ruled out) --COGDT 10/e, p 333, 334Correction of hypofibrinogenemia (i.e. Option "b")"A rational approach (in abruptio) should be to withhold any specific therapy to rectify the coagulation disorders except in the circumstances such as overt bleeding or clinically evaluated thromboembolic process". --Dutta Obs. 6/e, p 260
Induction of labor
Rx of hypofibrinogenemia then blood transfusion
Simultaneous emptying of uterus and blood transfusion
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Antepartum Haemorrhage