Sudden-onset Painless Vaginal Bleeding in Obstetrics & Gynecology — Case | General Gynecology | SMLE Q#18642

A 30-year-old G4P3 woman at 31+4 weeks’ gestation presents with sudden-onset painless vaginal bleeding for 2 hours. She reports normal fetal movements and no abdominal pain or contractions. She has had two prior cesarean deliveries and a prior pregnancy complicated by antepartum hemorrhage. The uterus is soft and non-tender. Speculum examination shows blood in the vaginal vault; digital vaginal examination is avoided. Bedside ultrasound shows an anterior placenta completely covering the internal cervical os. The hospital lacks blood bank services, operating theater readiness, and neonatal intensive care support. What is the most appropriate action?