Management of placental abruption is best described as:

• A. Emergent delivery in all cases
• B. Management depending on gestational age and fetal distress, including steroids for lung maturity, continuous fetal monitoring, and emergent delivery PRN
• C. Bed rest only
• D. No fetal monitoring required

Answer: (B)

Placental abruption is managed with a flexible plan based on how far along the pregnancy is and how the mother and fetus are doing. The condition can range from a small separation with stable mother and fetus to significant hemorrhage with fetal distress, so there isn’t one universal approach. The best management focuses on stabilization, careful monitoring, and delivering when necessary.

If the fetus is preterm but there are signs of distress or ongoing hemorrhage, steroids to promote lung maturity are given when delivery is anticipated within a short time frame, and the mother is closely monitored with continuous fetal heart rate monitoring to detect nonreassuring patterns. If the mother or fetus becomes unstable or if the pregnancy is term, emergent delivery is indicated to protect both lives. When the situation is stable and the fetus is not yet in distress, management may be more conservative with vigilant monitoring and preparation for possible delivery if the condition worsens.

This approach contrasts with the other options because it recognizes the need for ongoing fetal monitoring and the possibility of expectant management until delivery is warranted, rather than universal immediate delivery, and it avoids relying on bed rest alone or neglecting fetal monitoring, both of which would inadequately address the risks associated with abruption.