This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Gynaecology & Obstetrics
[{'content': 'Expectant management of placenta previa includes all except \nSelect and explain. \nA. Anti D, B. Cervical encirclage, C. Blood transfusion, D. Steroids', 'role': 'user'}, {'content': 'Answer: B \nExplanation: Macafee and Johnson regime is the name given to the expectant management of placenta previa as it was advocated by McAfee and Johnson\nAim of expectant management in case of placenta previa is to continue pregnancy for fetal maturity without compromising the maternal health.\nPrerequisites for expectant management:\n\nAvailability of blood for transfusion whenever required\nFacilities for caesarean section should be available throughout 24 hours.\n\nCandidates: Suitable for expectant management are:\n\nMother in god health status- Hemoglobin > 10 gm%\nHematocrit > 30% and she should bev hemodynamically stable.\nDuration of pregnancy less than 37 weeks\nActive vaginal bleeding is absent\nFetal well being is assured by USG and cardiotocography\n\nThe expectant management is carried upto 37 weeks of pregnancy until baby matures.\nExpectant management includes (i.e. MacAfee and Johnson regime includes)\n\nHospitalisation till active bleeding stops and then readmission at 34 weeks\nComplete bed rest\nAnaemia corrected with blood transfusion (if necessary), but blood should always to be kept ready as placenta previa is a recurrent condition.\nAntenatal steroids to promote fetal lung maturity\nAnti D if patient is Rh negative\nIf uterine contractions are present - tocolytics (magnesium sulphate/nifedipine) can be given as it leads to more advanced gestational age at delivery, greater birth weight of fetus, less neonatal complications, and decreased cost of hospitalization. Tocolytics should not be used for more than 48 hours.\nSome obstetricians do cervical encirclage in case of placenta previa. The rationale behind the use of cervical cerclage in placenta previa, is that it limits the development of the low uterine segment brought about by advancing gestation and the effect of uterine contraction. But other studies have failed to confirm these findings. Thus, RCOG doesnot recommend the use of cervical cerclage in placenta previa till further data is available', 'role': 'assistant'}]