Expectant management of placenta previa include following except: (AIPG 2011)
Expectant Treatment in Placenta Previa
a. Advocated by:
Macafee and Johnson (1945), in an attempt to improve the fetal salvage without increasing undue maternal hazards.
To continue pregnancy for fetal maturity without compromising the maternal health.
c. Vital prerequisites:
i. Availability of blood for transfusion whenever requireD.
ii. Facilities for caesarean section should be available throughout 24 hours, should it prove necessary.
d. Suitable cases for expectant management are:
i. Mother is in good health status (Hemoglobin ~ 10 gm %; hematocrit > 30%).
ii. Duration of pregnancy is less than 37 weeks.
iii. Active vaginal bleeding is absent.
iv. Fetal well-being is assured (USG).
e. Conduct of expectant treatment:
i. Bed rest with bathroom privileges.
ii. Periodic inspection of the vulval pads and fetal surveillance with USG at interval of 2-3 weeks.
iii. Supplementary haematinics should be given and the blood loss is replaced by adequate cross matched blood transfusion, if the patient is anaemic.
iv. When the patient is allowed out of, the bed (2-3 days after the bleeding stops), a gentle speculum (Cusco’s) examination is made to exclude local cervical and vaginal lesions for bleeding. However, their presence does not negate placenta praevia.
v. Use of tocolytics and cervical circlage are not helpful.