Caesarean Section — Practice
A 31-year-old G2P1 at 29 weeks of gestation presents with sudden painless bright red bleeding per vaginum. She has had a previous lower segment caesarean section. Ultrasound shows the placenta covering the internal os, with multiple lacunae, loss of the retroplacental clear zone and bridging vessels extending into the bladder wall. Which is the most appropriate definitive management plan?
AEmergency vaginal delivery with oxytocics
BPlanned caesarean hysterectomy at 34-36 weeks in a tertiary centre
CConservative bed rest until 40 weeks then normal delivery
DImmediate medical termination with mifepristone