Q: My 30 years old wife is having amenorrhea for the last 5 months. The placental position is low lying towards the internal os. She is getting p/v bleeding off and on. Will she be able to deliver the child? Please advise.

A:Placenta previa diagnosed as early as the 5th month will need continuous bed rest, no work, no sex, with blood arranged, and easy and quick access to a hospital if currently there is no bleeding. In case of active fresh bleeding, she will need to be hospitalised and kept stable with blood arranged, as massive bleeding can occur at any time. If bleeding gets controlled, the pregnancy may continue in 50 -60% cases beyond 32 to 34 weeks, by which time the maturity will be better. The ideal is to deliver at 38 weeks by caesarean section, but in case of bleeding/ fetal heart rate slowing/ growth problems, the baby may need to be delivered even earlier than 36 weeks - in which case a nursery facility too maybe necessary after birth.