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Postpartum contraception after venous thromboembolism — USMLE Step 3 MCQ

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HardOB/GYNPostpartum contraception after venous thromboembolismUSMLE Step 3

Transvaginal color Doppler at 30 weeks confirms fetal vessels crossing the internal cervical os in a singleton pregnancy. The patient is asymptomatic and membrane rupture has not occurred. Which delivery plan is most appropriate?

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Correct answer: CPlan cesarean delivery at 34 to 37 weeks before labor or membrane rupture

The best answer is “Plan cesarean delivery at 34 to 37 weeks before labor or membrane rupture”. Vasa previa places unprotected fetal vessels at risk of catastrophic rupture during labor or membrane rupture. Planned prelabor cesarean in the recommended gestational window balances hemorrhage risk against prematurity; timing is individualized with symptoms, cervical findings and logistics.

Reference: SMFM Consult Series #37: Diagnosis and Management of Vasa Previa: https://publications.smfm.org/publications/215-society-for-maternal-fetal-medicine-consult-series-37/