Good outcome with vasa previa depend on prenatal diagnosis and delivery by cesarean before rupture of the membranes. Consideration should be given to hospitalization at about 30-32 weeks and administration of corticosteroids to promote fetal lung maturation. Delivery should occur at an institution where there are adequate facilities for neonatal resuscitation that might include emergent blood transfusions. It is preferable, that before surgery, the surgeon is aware of the position of the fetal vessels and plans the incision to avoid lacerating these vessels. A gestational age of between 35 to 36 weeks is the optimal age for cesarean delivery in women with vasa previa, with a reasonable trade off between prematurity with the risk of respiratory distress syndrome and that of rupture of the membranes with the risk of fetal exsanguination and death.