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. 2013 Aug;122(2 Pt 1):352-357.
doi: 10.1097/AOG.0b013e31829cac58.

Vasa previa: clinical presentations, outcomes, and implications for management

Richard Bronsteen  1 , Amy Whitten, Mamtha Balasubramanian, Wesley Lee, Robert Lorenz, Mark Redman, Luis Goncalves, David Seubert, Sam Bauer, Christine Comstock
Affiliations

Vasa previa: clinical presentations, outcomes, and implications for management

Richard Bronsteen et al. Obstet Gynecol. 2013 Aug.

Abstract

Objective: To review experience with diagnosis, clinical associations, and outcomes of vasa previa in a single institution.

Methods: This was a retrospective review of all identified vasa previa cases from January 1 1990, to June 30, 2010.

Results: Sixty cases of vasa previa were identified (53 singletons, seven twins); 56 cases were diagnosed before delivery. An abnormal cord insertion or abnormal placental location was present in 55 cases. Missed diagnoses were attributed to technical and observer factors. Preterm bleeding was encountered in 25 (42%) case group participants. Seven case group participants required an emergent delivery, with significant neonatal morbidity and mortality. Twin pregnancies had a significantly earlier median age at delivery of 32 weeks of gestation compared with 35 weeks of gestations in singletons (P=.01). The seven twin pregnancies had a 28.6% emergent preterm delivery rate, whereas singletons had a 4.1% rate (P=.07). In 14 case group participants, the membranous fetal vessel was located in the lower uterus and not directly over the cervix. The vessel location was not related to the risk of emergent delivery.

Conclusion: Transvaginal ultrasound scans of at-risk patients can identify most cases of vasa previa. Preterm bleeding does not usually require immediate delivery. The rate of emergent preterm delivery was low in singleton pregnancies. Twins were delivered, on average, 3 weeks earlier than singletons.

Level of evidence: III.

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References

    1. Oyelese Y, Catanzarite V, Prefumo F, Lashley S, Schachter M, Tovbin Y, et al.. Vasa previa: the Impact of prenatal diagnosis on outcome. Obstet Gynecol 2004;103:937–42.
    1. Catanzarite V, Maida C, Thomas W, Mendoza A, Stanco L, Piacquadio KM. Prenatal sonographic diagnosis of casa previa: ultrasound findings and obstetric outcome in ten cases. Ultrasound Obstet Gynecol 2001;18:109–15.
    1. Baulies S, Maiz N, Muñoz A, Torrents M, Echevarría M, Serra B. Prenatal ultrasound diagnosis of vasa praevia and analysis of risk factors. Prenat Diagn 2007;27:595–9.
    1. Cipriano LE, Barth WH Jr, Zaric GS. The cost-effectiveness of targeted or universal screening for vasa praevia at 18-20 weeks of gestation in Ontario. BJOG 2010;117:1108–18.
    1. Oyelese KO, Turner M, Lees C, Campbell S. Vasa previa: an avoidable obstetric tragedy. Obstet Gynecol Surv 1999;54:138–45.

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