Vasa Praevia: a descriptive review of existing literature and the evolving role of ultrasound in prenatal screening

Abstract

Introduction: Literature addressing the feasibility of prenatal detection of vasa praevia during the mid-trimester morphology ultrasound scan is scarce, as is a lack of consensus about the appropriate management of pregnancies once it is detected. Method: The following descriptive review will provide historical context about the clinical significance, epidemiology, diagnosis and outcomes of pregnancies complicated by vasa praevia. It will also examine the role of ultrasound in the diagnosis of vasa praevia, and will examine current evidence surrounding this debate of whether routine screening for vasa praevia is possible, beneficial, or cost-effective. Conclusion: Finally, it will highlight the need for increased research into effective management of pregnancies at high risk of, or affected by vasa praevia to reduce fetal mortality and maternal and fetal morbidity associated with the condition.

Keywords: antenatal; bilobed placenta; colour Doppler; placental complications; screening; ultrasound; vasa praevia; velamentous umbilical cord insertion.