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': 'A primigravida at 37 week of gestation reported to labour room with central placenta previa with heavy bleeding per vaginum. The fetal heart rate was normal at the time of examination. The best management option of her is: \nSelect and explain. \nA. Expectant management, B. Cesarean section, C. Induction and vaginal delivery, D. Induction and forceps delivery', 'role': 'user'}, {'content': 'Answer: B \nExplanation: The patient in the question:\n\nHas gestational age = 37 weeks i.e. fetus has attained maturity so immediate termination of pregnancy is recommended.\nHas central placenta previa Type IV i.e. vaginal delivery is contraindicated, cesarean section has to be done.\nPatient is having heavy bleeding.\n\nAccording to Fernando Arias 3/e, p 337\n“In patients with heavy bleeding an efficient management plan including life support measures and immediate operative intervention is the only way to avoid a maternal death.”\nIt further says – on p 339\n“Patients with placenta previa and severe bleeding should be delivered by cesarean section irrespective of the type of placenta previa.”\nSo, from the above discussion, it is very much clear that in this patient, immediate cesarean section is the best resort. Friends, here I want to point out that earlier it was said that for minor degrees of placenta previa, vaginal delivery can be tried, but now, irrespective of degree of placenta previa, cesarean section is done and recommended.', 'role': 'assistant'}]