Vasa praevia rupture in velamentous insertion of the umbilical cord: The importance of prenatal diagnosis

Rodríguez, María Jesús; Moneo, E. de Frutos; Llanos, Santiago Nieto; Pollán, J. Clemente

doi:10.1016/j.anpede.2013.10.018

Cited by 2 publications

(5 citation statements)

References 20 publications

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“…Five articles were found discussing case reports of 10 cases of vasa praevia of which eight were prenatally diagnosed, two were discovered post-delivery and had resulted in neonatal death of the fetus. [19][20][21][22][23] The case reports discuss differing techniques used to prenatally diagnose the vasa praevia; however, as these case reports describe individual cases, no standard protocol is discussed. The diagnostic technique used varied between transabdominal scanning with the use of colour flow Doppler in the uterine segment 19 to transabdominal scanning with colour flow Doppler and three-dimensional imaging 21 and then transabdominal, transvaginal and colour flow Doppler.…”

Section: Reviewmentioning

confidence: 99%

“…19,20 Two of the authors discussing case reports do not discuss what ultrasound scanning protocol was used on each of the patients so no conclusion can be made. 22,23 Results from the retrospective reviews found that of the 265 cases reported, 59 intrapartum or neonatal deaths occurred due to the vasa praevia presence. 13,15,17 Oyelese et al 13 also reported a pregnancy which resulted in a still birth; however, this was not thought to be linked to the diagnosis of vasa praevia.…”

Section: Reviewmentioning

confidence: 99%

“…Emergency caesarean section was performed in both cases; however, due to loss of blood and pale floppy, anaemic fetus this resulted in the neonatal death on day 1 in both cases. 22,23 The selected studies were limited in the data available for review; therefore, no statistical analysis could be completed. It should also be acknowledged that of the studies reviewed, the authors note that there is likely to be some degree of bias present due to the motivation to conduct the research and case selection within a 'high risk population'.…”

Section: Reviewmentioning

confidence: 99%

“…19,20 Two of the authors discussing case reports do not discuss what ultrasound scanning protocol was used on each of the patients so no conclusion can be made. 22,23…”

Section: Reviewmentioning

confidence: 99%

“…Emergency caesarean section was performed in both cases; however, due to loss of blood and pale floppy, anaemic fetus this resulted in the neonatal death on day 1 in both cases. 22,23…”

Section: Reviewmentioning

confidence: 99%

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Is ultrasound screening for vasa praevia clinically justified and a financially viable screening test? A literature review

Gillian

Venables

2018

Ultrasound

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Vasa praevia is an obstetric complication currently not screened for within the United Kingdom, which if undetected prenatally can lead to fetal death when the membranes rupture. Internationally, guidelines are available providing guidance on the best screening policy and management pathways. However, the UK National Screening Committee and Royal College of Obstetricians and Gynaecologists do not support screening due to a lack of evidence. Recent studies explore the ability of ultrasound to detect vasa praevia prenatally in both the general and high-risk populations. Whilst there is no consensus on the 'best' screening strategy, the majority of authors note that targeted screening of the high-risk population is the most achievable and cost-effective strategy. Although not infallible, a standard screening protocol could identify the majority of cases in the high-risk group. Introduction of a screening strategy would affect training needs of professionals within the UK and would have implications on the need to produce guidelines on management and quality assurance. Further research is also needed to define a relevant high-risk population and explore how this would impact on service provision. This review explores the current evidence base for systematic screening and the implications for service.

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Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

“…19,20 Two of the authors discussing case reports do not discuss what ultrasound scanning protocol was used on each of the patients so no conclusion can be made. 22,23…”

Section: Reviewmentioning

confidence: 99%

“…Emergency caesarean section was performed in both cases; however, due to loss of blood and pale floppy, anaemic fetus this resulted in the neonatal death on day 1 in both cases. 22,23…”

Section: Reviewmentioning

confidence: 99%

See 3 more Smart Citations

Is ultrasound screening for vasa praevia clinically justified and a financially viable screening test? A literature review

Gillian

Venables

2018

Ultrasound

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Clinical Significance of Pregnancies Complicated by Velamentous Umbilical Cord Insertion Associated With Other Umbilical Cord/Placental Abnormalities

Suzuki

Katô

2015

J Clin Med Res

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BackgroundWe examined the clinical significance of pregnancies complicated by velamentous cord insertion (VCI) associated with other umbilical cord/placental abnormalities.MethodsData were collected from 168 deliveries complicated by VCI and from 16,797 unaffected controls. All placentae were screened identically by trained staff. In this study, we examined the presence of excessively long umbilical cord (longer than 70 cm), vasa previa, single umbilical artery, circumvallate placenta, succenturiate placenta, lobed placenta, placenta previa, low lying placenta and placenta accrete as the other umbilical cord/placental abnormalities.ResultsUsing a multivariate analysis, the pregnancies complicated by VCI were independently associated with in vitro fertilization use (P < 0.01), maternal smoking (P = 0.03), preterm delivery (P = 0.03), fetal asphyxia (P = 0.01) and small-for-gestational-age infants (P = 0.02). It was also independently associated with vasa previa (P < 0.01), single umbilical artery (P = 0.04), lobed placenta (P = 0.01) and placenta previa (P = 0.03). However, these umbilical cord/placental abnormalities were not associated with the further adverse outcomes of the pregnancies complicated by VCI.ConclusionVCI is associated with an increased risk of adverse perinatal outcomes irrespective of the presence of other umbilical cord/placental abnormalities. Routine identification of the placental cord insertion site should be considered.

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Vasa praevia rupture in velamentous insertion of the umbilical cord: The importance of prenatal diagnosis

Cited by 2 publications

References 20 publications

Is ultrasound screening for vasa praevia clinically justified and a financially viable screening test? A literature review

Is ultrasound screening for vasa praevia clinically justified and a financially viable screening test? A literature review

Clinical Significance of Pregnancies Complicated by Velamentous Umbilical Cord Insertion Associated With Other Umbilical Cord/Placental Abnormalities

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