A patient at 30 weeks gestation presents with complaints of vaginal bleeding. She is admitted to a labor room for evaluation. Fetal hea rate is 130 bpm with no accelerations or decelerations. Ultrasonography reveals a placenta covering a poion of the internal cervical os. She currently shows no active vaginal bleeding. The best management of this patient involves which of the following?
For the management, we follow McAfee Johnson Regime, the aim is to continue pregnancy for fetal maturity without compromising the maternal health. If the duration of pregnancy is <37 weeks, active vaginal bleeding is absent, mother and fetal well being is assured then resuscitation and observation in high risk ward is expected. Steroid therapy is indicated when the duration of pregnancy is less than 34 weeks.
Cesarean delivery
Resuscitation and observation in high risk ward
Amniocentesis to assess fetal lung maturity and plan delivery
Gentle cervical examination to assess dilatation and amnionic membrane status
Antepaum Haemorrhage