Third-trimester bleeding - immediate action?

• A. If no time for transport and delivery is imminent (crowning and pushing), proceed with delivery
• B. Transport immediately to a facility with obstetrical services
• C. Keep mother warm and wait for transport
• D. Administer intravenous fluids and monitor

Answer: (A)

When third-trimester bleeding is accompanied by signs that birth is imminent, the top priority is the safety of both mother and baby. If there isn’t enough time to reach a hospital and delivery is already imminent (crowning and pushing), the best action is to proceed with delivery in the field. Delaying to transport could mean the baby is born before you can get to care, increasing the risk of complications for both mother and newborn.

If you do have enough time to transport, the plan would be to move to a facility with obstetric services rather than try to deliver in transit. While you should still monitor the mother, keep her warm, and be ready to provide supportive care, delaying delivery when it’s clearly imminent is not appropriate.

In this imminent-delivery scenario, assisting with the birth and providing immediate post-delivery care (supporting the newborn, ensuring the mother is comfortable, and arranging rapid transport to a suitable facility as soon as possible) aligns with the urgency of the situation.