A 32-year-old pregnant woman, currently at 28 weeks of gestation, presents to the emergency department with painless, bright red vaginal bleeding. Upon obtaining her medical history, you learn that she was diagnosed with placenta previa earlier in her pregnancy. Based on these findings, what is the most appropriate initial management for this patient?
Administer a tocolytic agent to delay preterm labor.
Prepare equipment necessary for labor induction.
Conduct a manual pelvic examination to assess the extent of bleeding.
Administer supplementary oxygen and place the patient in a left lateral position.
The correct answer involves immediately placing the patient in a left lateral position to help maximize uteroplacental perfusion, as this eases the pressure on the vena cava and helps improve blood flow, which is critical in placenta previa cases involving bleeding. Administering supplementary oxygen is a supportive measure for fetal well-being in cases of maternal bleeding, but does not directly address the primary concern of uteroplacental insufficiency. Pelvic examinations should be avoided in cases of suspected placenta previa due to the risk of exacerbating the bleeding, and while preparing equipment for labor induction may be necessary later, it is not the most appropriate or immediate action required in this scenario.
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BCEN CEN
Gastrointestinal, Genitourinary, Gynecology, and Obstetrical
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