Vasa previa is diagnosed antenatally by Doppler demonstrating fetal vessels crossing the internal os. At what gestational age is planned cesarean delivery recommended for vasa previa to optimally balance fetal lung maturity versus risk of hemorrhage?
- A 36–37 weeks ✓
- B 34–35 weeks
- C 38–39 weeks
- D 40 weeks (await spontaneous labour)
Correct answer: A. 36–37 weeks
Explanation
Current evidence-based guidelines (SMFM 2015, RCOG 2011) recommend planned cesarean delivery for vasa previa at 36–37 weeks gestation to minimise the risk of spontaneous membrane rupture (which would cause fetal exsanguination from the crossing fetal vessels) while allowing sufficient fetal lung maturation. Delivery at 34–35 weeks incurs unnecessary prematurity risk; waiting beyond 37 weeks carries increasing risk of unplanned labour onset and vessel rupture.
Reference: Williams Obstetrics, 26th ed.
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Written and medically reviewed by the StethoPrep medical team.