Vasa praevia

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Vasa Previa - English Translation

Vasa praevia is a rare but serious obstetric complication where fetal blood vessels cross or run near the internal opening of the uterus. These vessels are at risk of rupture when the supporting membranes rupture, which can lead to fetal hemorrhage and death if not promptly managed.

Pathophysiology

In vasa praevia, the fetal blood vessels are not protected by the umbilical cord or the placenta. Instead, they traverse the fetal membranes, which are prone to rupture. This condition is often associated with velamentous cord insertion, where the umbilical cord inserts into the fetal membranes rather than the placental mass, and succenturiate lobe of the placenta, where an accessory lobe is present.

Diagnosis

Vasa praevia is typically diagnosed through ultrasound imaging, often during the second trimester. Color Doppler ultrasound is particularly useful in identifying the unprotected vessels. Early diagnosis is crucial for planning the mode and timing of delivery to prevent complications.

Management

Once diagnosed, the management of vasa praevia involves careful monitoring and planning for delivery. Elective cesarean section is usually recommended before the onset of labor, typically around 35-37 weeks of gestation, to prevent vessel rupture. Hospitalization from around 30-32 weeks may be advised to ensure immediate medical intervention if preterm labor occurs.

Prognosis

With early diagnosis and appropriate management, the prognosis for vasa praevia can be significantly improved. The risk of fetal mortality is high if the condition is not identified before labor, but with planned cesarean delivery, the outcomes are generally favorable.

Related Conditions

• Placenta previa
• Velamentous cord insertion
• Succenturiate lobe
• Abruption placentae

See Also

• Obstetrics
• Prenatal diagnosis
• High-risk pregnancy

External Links

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