A 28-year-old G2P1 at 36 weeks with known placenta previa develops heavy painless vaginal bleeding. She is hemodynamically stable and the fetal heart rate is reactive. Gestational age is confirmed at 36 weeks. What is the most appropriate delivery plan?

• A Induction of labor with oxytocin
• B Emergency cesarean section immediately
• C Expectant management until 40 weeks
• D Elective cesarean section at 37 weeks ✓

Explanation

For placenta previa with significant bleeding at 36 weeks, once the patient is stabilized and fetal lung maturity is adequate, delivery is planned. Elective cesarean at 37 weeks is standard. Induction is contraindicated in previa. Immediate cesarean is reserved for uncontrolled hemorrhage or fetal distress.

Reference: Williams Obstetrics, 26th ed.

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Written and medically reviewed by the StethoPrep medical team.