A patient at 34 weeks gestation with placenta previa is admitted; what plan of care is most important?

• A. Continuous fetal heart monitoring and insertion of a large-bore intravenous access.
• B. Immediate cesarean section.
• C. Discontinue all IV access.
• D. Place in isolation.

Answer: (A)

Placenta previa raises the risk of sudden painless vaginal bleeding and potential heavy hemorrhage. At 34 weeks, the priority is to protect both the fetus and the mother by watching the fetal status continuously so any distress or changes can be detected promptly, and by ensuring there is rapid access to fluids and blood products if bleeding occurs. A large-bore IV line is essential for swift resuscitation and transfusion if hemorrhage develops. Immediate cesarean delivery is not automatically required when the patient is stable, so it isn’t the default plan unless bleeding or labor starts. Isolation isn’t indicated unless another infectious risk is present, and discontinuing IV access would leave the patient unprotected in case of hemorrhage. So the combination of continuous fetal monitoring and ready IV access best addresses the immediate risks with placenta previa at this stage.