Question

In the expectant management of placenta praevia, all of the following are done except?

• A. Cervical cerclage (encirclage)
• B. Anti-D administration
• C. Corticosteroid administration
• D. Blood transfusion

Hint:

Cerclage treats an incompetent cervix, not a misplaced placenta.

Answer 1

The Correct Option is A

Step 1: Understand expectant (conservative) management of placenta praevia. It is offered to a stable, preterm patient (usually < 37 weeks) whose bleeding has settled, with the aim of prolonging the pregnancy to gain fetal maturity (Macafee and Johnson regimen).
Step 2: Review the standard components. Corticosteroids are given between 24 and 34 weeks to promote fetal lung maturity in anticipation of preterm delivery. Blood transfusion or keeping cross-matched blood ready is part of resuscitation and correcting anaemia from antepartum haemorrhage. Anti-D immunoglobulin is given to Rh-negative mothers who bleed, to prevent isoimmunisation.
Step 3: Evaluate cervical cerclage. Placenta praevia is an abnormally low-lying placenta; the bleeding is from placental separation at the lower segment, not from cervical incompetence. A cerclage suture around the cervix does not stop praevia bleeding and is not a recognised part of expectant management.
Step 4: Therefore the procedure that is NOT done is cervical cerclage.
Answer: Option A, Cervical cerclage.