A primigravida presents to casually at 32 weeks gestation with acute pain abdomen for 2 hours, vaginal bleeding and decreased fetal movements. She should be managed by:
Antepaum haemorrhage (Vaginal bleeding), with acute pain abdomen and fetal distress suggests a diagnosis of abruption placenta. Definitive treatment involves expediting the delivery to prevent maternal complications and give a chance of survival to the fetus. Presence of fetal distress is an indication of caesarean section and hence immediate caesarean section is the single best management option here. Ref: Dutta's Textbook of Gynaecology, 6th Edition, Pages 257, 259; Manual of Pathology of The Human Placenta: Second Edition By Rebecca N. Baergen, Ku Benirschke, 2010, Page 359.
Immediate cesarean section
Immediate induction of labor
Tocolytic therapy
Magnesium sulphate therapy