Prenatally diagnosed vasa previa: association with adverse obstetrical and neonatal outcomes

Westcott, Jill M.; Simpson, Scott W.; Chasen, Stephen T.; Vieira, Luciana; Stone, Joanne; Doulaveris, Georgios; Dar, P.; Bernstein, Peter S.; Atallah, Fouad; Dolin, Cara D.; Roman, Ashley S.

doi:10.1016/j.ajogmf.2020.100206

Cited by 20 publications

(51 citation statements)

References 14 publications

(10 reference statements)

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“…It is obvious that inpatient management will increase the chances to monitor uterine activity and abnormal fetal heart rate patterns, and this situation will therefore increase the rate of medical interventions. In our study, however, the timing of the delivery was comparable to other reports [18,[22][23][24], and appropriate intervention seems to have been undertaken to avoid fetal/neonatal exsanguination. The issue of elective hospitalization should be further assessed in prospective studies with a larger patient population.…”

Section: Discussionsupporting

confidence: 85%

Placental Types and Effective Perinatal Management of Vasa Previa: Lessons from 55 Cases in a Single Institution

Tachibana

Misugi

Pooh³

et al. 2021

Diagnostics

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Background: We aimed to identify clinical characteristics and outcomes for each placental type of vasa previa (VP). Methods: Placental types of vasa previa were defined as follows: Type 1, vasa previa with velamentous cord insertion and non-type 1, vasa previa with a multilobed or succenturiate placenta and vasa previa with vessels branching out from the placental surface and returning to the placental cotyledons. Results: A total of 55 cases of vasa previa were included in this study, with 35 cases of type 1 and 20 cases of non-type 1. Vasa previa with type 1 showed a significantly higher association with assisted reproductive technology, compared with non-type 1 (p = 0.024, 60.0% and 25.0%, respectively). The diagnosis was significantly earlier in the type 1 group than in the non-Type 1 group (p = 0.027, 21.4 weeks and 28.6 weeks, respectively). Moreover, the Ward technique for anterior placentation to avoid injury of the placenta and/or fetal vessels was more frequently required in non-type 1 cases (p < 0.001, 60.0%, compared with 14.3% for type 1). Conclusion: The concept of defining placental types of vasa previa will provide useful information for the screening of this serious complication, improve its clinical management and operative strategy, and achieve more preferable perinatal outcomes.

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Section: Discussionsupporting

confidence: 85%

Placental Types and Effective Perinatal Management of Vasa Previa: Lessons from 55 Cases in a Single Institution

Tachibana

Misugi

Pooh³

et al. 2021

Diagnostics

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“…Perinatal survival rate is dependent on appropriate prenatal diagnosis and improves from 72% versus 97% when vasa praevia is detected antenatally [ 49 , 50 ]. Even if a correct prenatal diagnosis occurs, almost 70% of newborns receive NICU treatment due to the complications of prematurity [ 51 , 52 , 53 , 54 ]. Transvaginal ultrasound and color Doppler ultrasound are the gold standard diagnostic modalities [ 53 ]; however, due to the low incidence of this condition, there are no population screening protocols, and the screening approach is indicated only in high-risk patients [ 55 , 56 ], such as low-lying placenta/placenta praevia, velamentous cord insertion, ART and multiple gestations [ 52 ].…”

Section: Resultsmentioning

confidence: 99%

“…Even if a correct prenatal diagnosis occurs, almost 70% of newborns receive NICU treatment due to the complications of prematurity [ 51 , 52 , 53 , 54 ]. Transvaginal ultrasound and color Doppler ultrasound are the gold standard diagnostic modalities [ 53 ]; however, due to the low incidence of this condition, there are no population screening protocols, and the screening approach is indicated only in high-risk patients [ 55 , 56 ], such as low-lying placenta/placenta praevia, velamentous cord insertion, ART and multiple gestations [ 52 ]. Elective Cesarean section should be planned around 35 weeks and not after 37 week’s gestation [ 57 ], and although no significant statistical differences were seen in the rate of neonatal complications between inpatient vs. outpatient management, in the outpatient group, a higher risk of an emergency Cesarean section was reported [ 58 ] ( Figure 16 and Figure 17 ).…”

Section: Resultsmentioning

confidence: 99%

Placental and Umbilical Cord Anomalies Diagnosed by Two- and Three-Dimensional Ultrasound

et al. 2022

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The aim of this review is to present a wide spectrum of placental and umbilical cord pathologies affecting the pregnancy. Placental and umbilical cord anomalies are highly associated with high-risk pregnancies and may jeopardize fetal well-being in utero as well as causing a predisposition towards poor perinatal outcome with increased fetal and neonatal mortality and morbidity. The permanent, computerized perinatology databases of different international centers have been searched and investigated to fulfil the aim of this manuscript. An extended gallery of prenatal imaging with autopsy correlation in specific cases will help to provide readers with a useful iconographic tool and will assist with the understanding and definition of this critical obstetrical and perinatological issue.

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“…Figure 1 shows the selection scheme used in this study. First, 1364 studies were identified, and 20 studies met the study criteria for descriptive analysis [ 14 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 ]. Two studies reported by Suzuki et al [ 36 , 37 ] used overlapped data (due to overlapping study periods); however, the outcome of interest was different in these studies.…”

Section: Resultsmentioning

confidence: 99%

“…Regarding the study type ( n = 20), all studies were retrospective in nature, 14 were original articles, 4 were case series, and 2 were case reports. Of these ( n = 20), the published years were between 1998 and 2022, and all studies were retrospective [ 14 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 ]. No prospective studies or randomized controlled trials have been reported.…”

Section: Resultsmentioning

confidence: 99%

The Characteristics and Obstetric Outcomes of Type II Vasa Previa: Systematic Review and Meta-Analysis

et al. 2022

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Vasa previa is a rare fetal life-threatening obstetric disease classified into types I and II. This study aimed to examine the characteristics and obstetric outcomes of type II vasa previa. A systematic review was performed, and 20 studies (1998–2022) were identified. The results from six studies showed that type II vasa previa accounted for 21.3% of vasa previa cases. The characteristics and obstetric outcomes (rate of assisted reproductive technology (ART), antenatal diagnosis, emergent cesarean delivery, maternal transfusion, gestational age at delivery, and neonatal mortality) were compared between type I and II vasa previa, and all outcomes of interest were similar. The association between ART and abnormal placenta (bilobed placenta or succenturiate lobe) was examined in three studies, and the results were as follows: (i) increased rate of succenturiate lobes (ART versus non-ART pregnancy; OR (odds ratio) 6.97, 95% confidence interval (CI) 2.45–19.78); (ii) similar rate of abnormal placenta (cleavage-stage versus blastocyst embryo transfer); (iii) increased rate of abnormal placenta (frozen versus fresh embryo transfer; OR 2.97, 95%CI 1.10–7.96). Although the outcomes of type II vasa previa appear to be similar to those of type I vasa previa, the current evidence is insufficient for a robust conclusion.

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Prenatally diagnosed vasa previa: association with adverse obstetrical and neonatal outcomes

Cited by 20 publications

References 14 publications

Placental Types and Effective Perinatal Management of Vasa Previa: Lessons from 55 Cases in a Single Institution

Placental Types and Effective Perinatal Management of Vasa Previa: Lessons from 55 Cases in a Single Institution

Placental and Umbilical Cord Anomalies Diagnosed by Two- and Three-Dimensional Ultrasound

The Characteristics and Obstetric Outcomes of Type II Vasa Previa: Systematic Review and Meta-Analysis

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