Vasa previa screening strategies: decision and cost‐effectiveness analysis

Sinkey, Rachel G.; Odibo, Anthony O.

doi:10.1002/uog.19098

Cited by 30 publications

(33 citation statements)

References 39 publications

(63 reference statements)

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“…5,6 The present report supports previous observations that IVF is a risk factor for VP, and transvaginal ultrasound screening for VP appears to be most cost-effective when performed among IVF pregnancies. 7 Jauniaux et al 8 found an incidence of bilobed and succenturiate-lobed placenta of 22% in the IVF group compared with 6% in the control group. Abnormal umbilical cord insertion with normal placental morphology has been associated with IVF.…”

Section: Discussionmentioning

confidence: 96%

In Vitro Fertilization and Vasa Previa: A Report of Two Cases

Isotton

Salazar

Peralta³

et al. 2019

Rev Bras Ginecol Obstet

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Vasa previa (VP) is a dangerous obstetric condition associated with perinatal mortality and morbidity. In vitro fertilization (IVF) is a risk factor for VP due to the high incidence of abnormal placentation. The diagnosis should be made prenatally, because fetal mortality can be extremely high. We report two cases to demonstrate the accuracy of transvaginal ultrasound in the prenatal diagnosis of VP. A 40-year-old primiparous Caucasian woman with IVF pregnancy was diagnosed with VP at 29 weeks of gestation and was hospitalized for observation at 31 weeks of gestation. She delivered a male newborn weighing 2,380 g, with an Apgar score of 10 at 5 minutes, by elective cesarean section at 34 weeks + 4 days of gestation, without complications. A 36-year-old primiparous Caucasian woman with IVF pregnancy was diagnosed with placenta previa, bilobed placenta increta and VP. The cord insertion was velamentous. She was hospitalized for observation at 26 weeks of gestation. She delivered a female newborn weighing 2,140 g, with an Apgar score of 9 at 5 minutes, by emergency cesarean section at 33 weeks + 4 days of gestation due to vaginal bleeding. The prenatal diagnosis of VP was associated with a favorable outcome in the two cases, supporting previous observations that IVF is a risk factor for VP and that all IVF pregnancies should be screened by transvaginal ultrasound.

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Section: Discussionmentioning

confidence: 96%

In Vitro Fertilization and Vasa Previa: A Report of Two Cases

Isotton

Salazar

Peralta³

et al. 2019

Rev Bras Ginecol Obstet

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“…Velamentous umbilical cord insertion is also related to the occurrence of vasa previa . Therefore, in patients with velamentous umbilical cord insertion, low‐lying placenta, or abnormal placental morphology, the diagnosis of vasa previa must be considered . The American College of Obstetricians and Gynecologists also recommends the use of color Doppler in patients who are at a high risk for vasa previa .…”

Section: Discussionmentioning

confidence: 99%

Prenatal diagnosis of vasa previa and the course of the cord vessels contribute to the safety of cesarean sections: A case report

Aoki

Obata

Odagami

et al. 2019

Clinical Case Reports

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“…RANZCOG recommendation three defines vasa praevia as fetal vessels that run through bare membranes that lie on or are within 20 mm of the cervical IOS (Table ). In the survey, only 29% of sonographers used this definition (Figure ) indicating an unfamiliarity of the threshold measurement recommended in the literature to quantify a vasa praevia.…”

Section: Discussionmentioning

confidence: 99%

“…2,11 A low-lying placenta in the mid-trimester ultrasound is defined as the lower placental edge being 20 mm or less from the cervical IOS. 2,8,13,15 From the survey, 99% of participants do this measurement; however, there was a disparity in the range of measurements used by sonographers, and only 51% of participants used the commonly accepted measurement ( Figure 4). When a low-lying placenta is identified transabdominally, sonographers should proceed to a transvaginal scan to improve diagnostic accuracy of their measurement.…”

Section: Figurementioning

confidence: 99%

Detection of vasa praevia in the mid‐trimester ultrasound by Australian sonographers

et al. 2019

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Objective To ascertain Australian obstetric sonographers knowledge and current practice when assessing for vasa praevia in the mid‐trimester ultrasound with the view to improve prenatal diagnosis. Methods Between August and September 2018, a survey was emailed to 4868 Australian sonographers registered to participate in Australian Sonography Association Registry (ASAR) facilitated research projects. A total of 577 responses were received. The sonographers survey response was compared with published Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) recommendations. Results There appears to be an unfamiliarity with the RANZCOG recommendations, in particular that vasa praevia is defined as a fetal vessel lying within 20 mm of the cervical internal os (IOS). Transabdominally, if a vasa praevia risk factor is identified (including a fetal vessel observed in the lower uterine segment), less than 48% of surveyed sonographers proceed to a targeted transvaginal scan. Conclusion To enable effective diagnosis of vasa praevia, it is important to recognise associated risk factors that can raise suspicion for a potential vasa praevia; these are velamentous cord insertion, succenturiate lobe, and low‐lying placenta. A lower threshold of performing a transvaginal ultrasound when risk factors are identified (including a fetal vessel is identified in the lower uterine segment) may significantly improve vasa praevia diagnosis in the mid‐trimester ultrasound.

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Vasa previa screening strategies: decision and cost‐effectiveness analysis

Cited by 30 publications

References 39 publications

In Vitro Fertilization and Vasa Previa: A Report of Two Cases

In Vitro Fertilization and Vasa Previa: A Report of Two Cases

Prenatal diagnosis of vasa previa and the course of the cord vessels contribute to the safety of cesarean sections: A case report

Detection of vasa praevia in the mid‐trimester ultrasound by Australian sonographers

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