OP26.03: Vasa previa: prenatal diagnosis and neonatal outcome

Bergann, A.; Lopez, A. Sarut; Chaoui, R.

doi:10.1002/uog.6911

Cited by 1 publication

(5 citation statements)

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“…The good outcome of the pregnancies with prenatally diagnosed vasa previa in this study is consistent with the findings of several other studies 4,7,8,10,14‐17 . Oyelese et al 4 found a lethality rate of 56% in pregnancies with undiagnosed vasa previa.…”

Section: Discussionsupporting

confidence: 93%

“…Furthermore, Bergann et al report one fetal demise due to vasa previa curving at a distance from the internal cervical os. 7 This supports the inclusion in the definition of vasa previa of chorionic vessels in the proximity of the internal cervical os.…”

Section: Discussionsupporting

confidence: 67%

“…Due to the lack of studies on the risk of bleeding complications regarding the spatial relation between the distance of fetal chorionic vessels and the internal os, a distinct cut‐off value for this distance cannot be given. Furthermore, Bergann et al report one fetal demise due to vasa previa curving at a distance from the internal cervical os 7 . This supports the inclusion in the definition of vasa previa of chorionic vessels in the proximity of the internal cervical os.…”

Section: Discussionmentioning

confidence: 86%

“…Prenatal diagnosis is feasible with a high accuracy 5 . Delivery by cesarean section before rupture of membranes occurs can significantly reduce the risk for the fetus 4,6‐17 …”

Section: Introductionmentioning

confidence: 99%

“…5 Delivery by cesarean section before rupture of membranes occurs can significantly reduce the risk for the fetus. 4,[6][7][8][9][10][11][12][13][14][15][16][17] However, there is still some debate regarding whether and to what extent screening for vasa previa should be incorporated into routine management of pregnancies. 18 The objective of our study was to examine the performance of our protocol for screening for vasa previa and its impact on fetal outcome.…”

Section: Introductionmentioning

confidence: 99%

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Systematic screening for vasa previa at the 20‐week anomaly scan

Gross

Ajd

Specht³

et al. 2021

Acta Obstet Gynecol Scand

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Introduction The presence of vasa previa carries a high risk for severe fetal morbidity and mortality due to fetal bleeding caused by injury to unprotected fetal vessels when rupture of membranes occurs. Previously, it has been shown that prenatal diagnosis significantly improves the outcome. However, systematic screening for vasa previa is not generally performed and clinical studies demonstrating the performance of systematic screening for vasa previa in routine clinical practice are rare. The objective of this study was to assess the performance of systematic screening for vasa previa by determining placental cord insertion at the 20‐week anomaly scan. Material and methods This is a retrospective study of 6038 pregnant women between 18+0 and 24+0 gestational weeks who were prospectively screened for vasa previa by depiction of the site of placental cord insertion at the 20‐week anomaly scan. Pregnancies with marginal or velamentous cord insertion underwent vaginal sonography for examination for vasa previa. In cases with succenturiate or bilobed placentas, the bridging vessels were depicted, and vaginal sonography was performed if necessary. Results There were 21 cases of vasa previa and all were diagnosed prenatally. In 18 cases, the cord insertion was marginal or velamentous. The remaining three cases had placental anomalies, which necessitated a detailed examination. All pregnancies with vasa previa were delivered at a mean of 35.2 (SD 1.8) gestational weeks by cesarean section. Among pregnancies affected by vasa previa, all fetuses survived. The median birthweight was 2390 g (range 1200–2990 g) and the mean umbilical artery pH 7.34 (SD 0.04). The median 5‐min APGAR score was nine (range 7–10). None of the fetuses or neonates died or required blood transfusions. In all pregnancies of the whole cohort which were complicated by fetal or neonatal demise and in neonates with a 5‐min APGAR score ≤5 and/or an umbilical artery pH ≤7.10, fetal blood loss was excluded as a cause of the poor obstetric outcome. Conclusions Screening for vasa previa is feasible and efficient, taking into account the site of placental cord insertion in pregnancies not affected by placenta previa and bilobed and succenturiate placenta.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 67%

Section: Discussionmentioning

confidence: 86%

“…Prenatal diagnosis is feasible with a high accuracy 5 . Delivery by cesarean section before rupture of membranes occurs can significantly reduce the risk for the fetus 4,6‐17 …”

Section: Introductionmentioning

confidence: 99%