22nd August 2023

A 29-year-old primigravida at 39 weeks gestation is in labour and develops sudden onset severe abdominal pain and heavy bleeding

A 29-year-old primigravida at 39 weeks gestation is in labour and develops sudden onset severe abdominal pain and heavy bleeding. The foetal heart rate is noted to be 60 bpm. Upon examination, the umbilical cord is palpable at the introitus.

What is the most appropriate course of action?