In placenta pre conservative treatment is not done in case of :
Ans. is a, b and c i.e. Active labour; Anencephaly; Dead baby; and Severe placenta pre Well friends, there is no need to "rattoo" the conditions where expectant management is required and where active management. For a while - forget all the lists and just think you are a gynae casualty medical officer and a pregnant female with vaginal bleeding in the late months of pregnancy comes to you (suspected case of placenta pre). How will you manage if : a. She is in active labour Obviously you will either do cesarean section or if bleeding is not much and no other adverse circumstances are present, proceed with vaginal delivery but you will never think of arresting her labour and managing conservatively b. If the patient is diagnosed of carrying anencephalic fetus. The aim of conservative management is to continue pregnancy for attaining fetal maturity without compromising the maternal health. But in this case when fetus is anencephalic there is no point in continuing pregnancy i.e active management / termination should be done. c. If fetus is dead Same is the case with dead fetus, there is no point in continuing pregnancy i.e. active management should be done d. Severe placenta pre Remember always A gynaecologists first aim should be to save the life of mother. If fetus can be saved nothing like it, but in order to save the fetus, mother's life should not be put at risk. So, in this case expectant management (conservative management) should not be done. Immediate termination of pregnancy by cesarean section is the correct management. e. Premature fetus If maternal condition is good. and fetus is premature. patient can be kept under observation. Betamethasone (to hasten fetal lung maturity) and blood transfusion (to raise mother's hernatocrit), shoud be given i.e in this case conservative management can be done. If fetus is dead
Active labour
Anencephaly
Dead baby and Severe placenta pre both
All of these