Management of Placenta Previa and Placental Abruption Placenta previa. If pregnancy 37 weeks or greater, or if fetal maturity has been documented, a cesarean section is indicated unless only a minimal degree of placenta previa is present. If bleeding is sufficient to jeopardize the mother or fetus despite transfusion, cesarean section may be indicated regardless of gestation. In the preterm gestation, expectant management is indicated in patients with no observed bleeding, reactive nonstress test, stable hematocrit, who are compliant with instructions. Most patients require inpatient observation.
Physical activity is restricted.
Nothing is allowed in the vagina, including examining fingers. Preterm labor can be managed with magnesium sulfate. Use of beta-adrenergic agents can cause tachycardia and mask the signs of bleeding. Once 36 to 37 weeks of gestation is reached with fetal maturity demonstrated by amniocentesis, the patient is readied for elective double-setup examination. Add 3 drops of maternal blood to one tube and 3 drops of vaginal blood to the other.