A 26-year-old woman at 28 weeks presents with painless vaginal bleeding. Ultrasound shows a velamentous cord insertion with fetal vessels crossing the internal os. What is the most appropriate management?
- A Elective cesarean at 35 to 36 weeks ✓
- B Expectant management with bed rest
- C Corticosteroids and delivery at 32 weeks
- D Amniocentesis for lung maturity
Correct answer: A. Elective cesarean at 35 to 36 weeks
Explanation
Vasa previa carries a high risk of fetal exsanguination if membranes rupture. Elective cesarean at 35 to 36 weeks after corticosteroid administration is recommended. Expectant management alone is insufficient given the catastrophic risk of fetal vessel rupture.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.