Vasa Previa: The Impact of Prenatal Diagnosis on Outcomes

Abstract

Good outcomes with vasa previa depend primarily on prenatal diagnosis and cesarean delivery at 35 weeks of gestation or earlier should rupture of membranes, labor, or significant bleeding occur.

Prenatal diagnosis and management of vasa previa in twin pregnancies: a case series and systematic review

“…It can lead to rapid fetal exsanguination and death [1][2][3][4][5] and the perinatal mortality of undiagnosed VP has been reported to be as high as 60%. 6 The incidence of VP has been reported to range between in 1 in 1200 to 1 in 5000 pregnancies but the condition may have been under-reported. [1][2][3][4][5] A recent systematic review of 10 cohort studies found that the incidence of VP is 0.6 per 1000 pregnancies.…”

“…Both cord anomalies are 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 5 5 low-lying placenta. [1][2][3][4][5][6][7][8] VCI and VP type I are also more common in twin pregnancies and monochorionicity doubles the risk for VCI compared to dichorinicity. 11,12 Maternal smoking has been recently reported as a risk factor for VCI and thus potentially of VP.…”

Vasa praevia: ultrasound diagnosis at the mid‐trimester scan

“…and Oyelese, et al 2 . The placental location will alter from the first to third trimesters, due to the formation of the lower uterine segment.…”

“…This concept of a low lying placenta at the mid‐trimester scan (without placenta praevia in the third trimester) was introduced by Oyelese in 1998 15 as a risk factor and discussed in more recent articles 2 8 …”

“…Oyelese, et al . 2 reported that prenatal diagnosis of vasa praevia by ultrasound reduced perinatal mortality from 56% to 3% in a large study of 155 cases of vasa praevia.…”