Management of placenta previa

1. In a pregnancy >36 weeks with documented fetal lung maturity, the neonate should be immediately delivered by cesarean section.

2. Low vertical uterine incision is probably safer in patients with an anterior placenta. Incisions through the placenta should be avoided.

3. If severe hemorrhage jeopardizes the mother or fetus, cesarean section is indicated regardless of gestational age.

4. Expectant management is appropriate for immature fetuses if bleeding is not excessive, maternal physical activity can be restricted, intercourse and douching can be prohibited, and the hemoglobin can be maintained at >10 mg/dL.

5. Rh immunoglobulin is administered to Rh-negative-unsensitized patients.

6. Delivery is indicated once fetal lung maturity has been documented.

7. Tocolysis with magnesium sulfate may be used for immature fetuses.

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