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Abnormal placentation is associated with excess risk for maternal hemorrhage, urgent delivery, and preterm birth. Sometimes imaging can be useful for antenatal diagnosis of placenta accreta (JW Womens Health Jan 21 2010); nonetheless, optimal delivery timing for women with placenta previa and accreta is controversial, and prospective trials are unlikely to be conducted. Investigators at Northwestern University used a decision-analytic approach to model outcomes associated with planned deliveries at gestational ages ranging from 34 to 39 weeks with varied management options (e.g., antenatal glucocorticoid administration, evaluation of fetal lung maturity).
Using published estimates of likelihood of adverse occurrences, such as neonatal respir…