37 weeks G2P1L1 is admitted with pain in abdomen since 2 h. O/E: Hb = 9 g%, BP 150/90 mmHg, and urine albumin +. P/A--36 weeks, fetal hea rate good with minimal contraction of uterus. P/V--6 cm dilated. ARM reveals blood stained liquor. Next line of management is:
This is a case of revealed abruption (pain, preeclampsia, and blood-stained liquor) all point to the diagnosis of abruption In abruption the aim should be to deliver the patient soon, as the bleeding stops only after the delivery of the placenta. If there is fetal distress immediate LSCS should be done. If the fetus is alive and there is no fetal distress and there is a possibility that delivery can happen soon (as in this case) then labor should be augmented by ARM and oxytocin drip, keeping a close watch on FHR. So remember that abruption is not an absolute indication for LSCS, it is a relative indication.
Caesarean section
Wait and watch
Oxytocin augmentation
Blood transfusion and wait for spontaneous progress of labour
Obstetrics