A nurse is reviewing charts for clients who have a diagnosis of placental abruption. Which of the following clients needs an emergent cesarean section?

Rationale: A. Although this client is hemorrhaging with a fetal demise, emergent cesarean delivery is not indicated when the fetus has already died. The priority is maternal stabilization and vaginal delivery if possible. Cesarean section in the presence of fetal demise is reserved for maternal indications only, such as uncontrolled bleeding or uterine rupture, which is not explicitly stated here. B. This client is at 37 weeks with a category II fetal heart tracing, which indicates fetal compromise, and has incomplete cervical dilation. Placental abruption can rapidly compromise fetal oxygenation. In this scenario, emergent cesarean delivery is indicated to prevent fetal death because vaginal delivery would take too long, and the fetus is showing signs of distress. Maternal vital signs are stable, so the priority is fetal well-being. C. This client is at 32 weeks but has stable maternal vital signs and a category I fetal heart tracing, indicating no fetal compromise. Immediate cesarean section is not warranted; careful monitoring and supportive care are appropriate. Delivery may be planned based on gestational age, maternal stability, and severity of abruption. D. Although the client is at term with a fetal demise, emergent cesarean is not indicated. The priority is maternal safety, and vaginal delivery is preferred unless there is uncontrolled maternal hemorrhage or other complications. Cesarean would increase maternal surgical risk without benefiting the fetus.