Vasa praevia

Vasa Praevia

Introduction

Vasa Praevia is a rare but potentially life-threatening obstetric condition where fetal blood vessels cross or run near the internal os of the uterus, beneath the fetal presenting part. These vessels are part of the umbilical cord or placental membranes and are at risk of rupture during labor or when the membranes rupture, leading to fetal compromise or loss due to rapid blood loss.

Vasa Previa - English Translation

Definition

Vasa praevia occurs when the blood vessels connecting the baby to the placenta lie across the entrance to the birth canal. These vessels are covered only by the fetal membranes without the protection of the umbilical cord or placental tissue, making them extremely vulnerable to injury.

Causes

The condition typically results from:

• Velamentous cord insertion, where the umbilical cord inserts into the fetal membranes rather than the placenta.
• Succenturiate-lobed placenta, where the placenta has one or more accessory lobes connected by blood vessels to the main part of the placenta.

Risk Factors

Factors increasing the risk of vasa praevia include:

• In vitro fertilization (IVF) pregnancies
• Multiple gestations (twins, triplets, etc.)
• History of uterine surgery or procedures
• Low-lying placenta or placenta previa

Diagnosis

Early diagnosis is crucial and can significantly improve outcomes. Vasa praevia is usually diagnosed through:

• Transvaginal ultrasound with color Doppler, which can identify the aberrant vessels.
• MRI, in cases where ultrasound results are inconclusive.

Treatment

The primary treatment for vasa praevia is delivery of the baby via cesarean section before labor begins and before the membranes rupture. Timing of the delivery is carefully considered to balance fetal maturity and the risk of vessel rupture.

Prognosis

With timely diagnosis and appropriate management, the prognosis for babies affected by vasa praevia is generally good. However, undiagnosed or late diagnosis of vasa praevia carries a high risk of fetal mortality.

See Also

• Placenta previa
• Umbilical cord
• Obstetric ultrasonography
• Cesarean section

References

• "Vasa Praevia: Diagnosis and Management." Journal of Obstetrics and Gynaecology.
• "Vasa Praevia: Clinical Presentations and Outcomes." BMC Pregnancy and Childbirth.

External Links

• American College of Obstetricians and Gynecologists
• Royal College of Obstetricians and Gynaecologists

Vasa praevia Resources
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