A 35-year-old woman with placenta previa at 36 weeks is admitted with moderate vaginal bleeding. She is hemodynamically stable, fetal heart rate is reactive, and she has completed a course of betamethasone. The BEST plan is:

• A Continue expectant management until 38 weeks
• B Induction of labor with oxytocin
• C Emergency cesarean section now
• D Elective cesarean section at 37 weeks ✓

Explanation

ACOG recommends elective cesarean delivery for placenta previa at 36 0/7 to 37 6/7 weeks after betamethasone if bleeding is stable. With completed steroids and moderate bleeding, delivery at 37 weeks balances prematurity risk against hemorrhage risk. Expectant management beyond 37 weeks increases bleeding risk without clear benefit.

Reference: ACOG Practice Bulletin No. 183: Postpartum Hemorrhage, 2017 (reaffirmed 2022) ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.