Vasa previa can occur on its own see figure vasa previa or with placental abnormalities, such as a. When vasa previa is diagnosed antenatally, an elective caesarean section should be offered prior to the onset of labour. Vasa praevia definition of vasa praevia by medical dictionary. Vasa previa is an uncommon but catastrophic obstetrical complication which often goes undiagnosed. Vasa previa is a rare but clinically important obstetrical complication that can be associated with a lowlying placenta or placenta previa. We aim to convey the challenges in diagnosing this condition by presenting 2 cases of pseudo vasa previa diagnosed antenatally as vasa previa using standard and color doppler ultrasonography.
These vessels are at risk of rupture when the supporting membranes rupture, as they are unsupported by the umbilical cord or placental tissue risk factors include lowlying placenta, in vitro fertilization. Vasa previa gynecology and obstetrics merck manuals. These vessels may travel through the membranes or amniotic sac. Less commonly, a vessel that courses over the edge of a. Katie is a mom who experienced a misseddiagnosis vasa previa pregnancy and nearly lost her daughter. Ruptured vasa previa in velamentous cord insertion placenta nature. Atypical vasa previa in a velamentous cord insertion identified. Vasa previa might be present if any of the following conditions exist. Pdf in utero laser treatment of type ii vasa previa researchgate. Article information, pdf download for vasa praevia. Pdf vasa previa, defined as fetal vessels coursing within the membranes between the presenting part and the cervix, occurs in approximately. Early suspicion of vasa previa with velamentous umbilical.
The blood vessels of the umbilical cord presenting before the fetus. Pregnancy complications, such as vasa previa, are problems that occur only during pregnancy. Before ultrasound became common practice, the diagnosis of vasa previa was often made too late on the triad of ruptured membranes, painless vaginal bleeding fetal bleeding. High index of suspicion is required to prevent fetal morbidity and mortality. Yet even in careful studies, the diagnosis of vasa previa is easy to. Vasa praevia is described as the unprotected fetal vessels traversing through. If vasa previa is suspected, transvaginal ultrasound colour doppler may be used to facilitate the diagnosis. If membranes rupture, these vessels may rupture, with resultant fetal hemorrhage, exsanguination, or even death. Painless bleeding occurs during spontaneous rupture of membranes fetal in origin mothers life is not at risk may lead to fetal exsanguination.
Early suspicion of vasa previa with velamentous umbilical cord insertion and low laying placenta and its management. This places the fragile umbilical vessels at risk for tearing. Vasa previa is a cause of sudden unanticipated fetal death, with a fetal. Vasa previa is a rare but potentially catastrophic cause of antepartum hemorrhage. Should we routinely screen highrisk women for this. Vasa previa fact sheet cause vasa previa occurs when fetal blood vessels from the placenta or umbilical cord cross the entrance to the birth canal, beneath the baby. Inquest but battling rebecca overcame the condition vasa praevia which kills 95 per cent of sufferers at birth.
This is a condition where the umbilical blood vessels course through the amnion and chorion and meet to form the umbilical cord a distance from the placental surface. First, there is a velamentous insertion of the umbilical cord. Published medical journals articles on vasa praevia. Abstract we present a case of a 34 years old female who was suspected to have vasa previa. Vasa previa occurs when membranes that contain fetal blood vessels connecting the umbilical cord and placenta overlie or are within 2 cm of the internal cervical os.
Posted on february 3, 2017 february 3, 2017 by lcline87. Article information, pdf download for atypical vasa previa in a. Vasa previa occurs when membranes that contain fetal blood vessels connecting the umbilical cord and placenta overlie or are within 2 cm of the internal. In the main these cases will go undiagnosed until birth and sadly, likely to result in the death of an otherwise healthy baby. Vasa praevia is a condition in which fetal blood vessels cross or run near the internal opening. Marked segmental thinning of the umbilical cord vessels.
Vasa praevia rupture in velamentous insertion of the umbilical cord. Risk factors include lowlying placenta, in vitro fertilization. Vasa previa also may accompany velamentous insertion of. Diagnosis and management of vasa previa sciencedirect. Prevalence the largest studies report a prevalence of 1. Even with the use of transvaginal ultrasound colour doppler, vasa previa may be missed.
The first ultrasound description of vasa previa dates back to 1987 2. These vessels are at risk of rupture when the supporting membranes rupture, as they are unsupported by the umbilical cord or placental tissue. In velamentous cord insertion, vessels from the umbilical cord run through part of the chorionic membrane rather than directly into the placenta. Todays vasa previa success story is brought to us by katie, a mom with a beautiful little girl who is truly a miracle. Lobstein reported the first case of rupture of vasa previa in 1801. Vasa is the plural form of vas, which denotes a vessel its the root of english words like vase, and previa from which we also get previous can be broken down into two componentspre, meaning before, and via, meaning way. Description vasa previa is a rare developmental disorder made up of two separate disorders.
Vasa previa, case presentation from a referral center in. Vasa previa must be distinguished from funic presentation prolapse with the umbilical cord between the presenting part and the internal cervical os, in which fetal blood vessels wrapped with wharton jelly can be seen covering the cervix. In vasa previa, membranes that contain blood vessels connecting the umbilical cord and placenta lie across or near the opening of the cervixthe entrance to the birth canal. The suspicion of vasa previa in a patient with low lying. Vasa previa refers to a situation where there are aberrant fetal vessels crossing over or in close proximity to the internal cervical os, ahead of the fetal presenting part. Benckisers hemorrhage and fetal distress or demise. Her story is so powerful and raw, and it put me in tears as i read it. Vasa praevia ou vasa previa e uma complicacao obstetrica na qual ha vasos fetais cruzando ou atravessando em proximidade com o orificio interno do cervice uterino. Deliver by cesarean section before the onset of labor and before rupture of membranes. A postmortem found the vasa praevia, an abnormal blood vessel in the placenta, had been ruptured during birth.
Vasa previa is a lifethreatening complication of a velamentous cord insertion. Differential diagnosis vaginal bleeding in pregnancy 20wks placental abruption. The 2 main causes of vasa previa are velamentous insertions where the cord inserts directly into the membranes, leaving unprotected vessels running to the placenta 2562% and vessels crossing between lobes of the placenta such as in succenturiate or bilobate placentas 3375% 36, 56. Published by maney publishing c british medical ultrasound society. Happy friday have you had a great week ill be honest, ive been an emotional mess over here but it seems like all those hormones have taken a chill pill towards the end of the. Older numbers are based on less reliable data and should probably be abandoned. About vasa praevia raising awareness the uk registered charity was set up because every year in the uk, this obstetric condition will affect approximately 555 pregnancies more than one per day. Vasa praevia definition of vasa praevia by medical. In funic presentation, unlike in vasa previa, the umbilical cord moves away from the cervix during. Vasa previa can therefore be understood to mean roughly, vessels in the way of the baby. Because of unanticipated sudden fetal demise, this is one of the most dreaded events in modern obstetrics.
Prenatal diagnosis of vasa previa by ultrasound scans is approximately 98%. Vasa praevia is a condition in which fetal blood vessels cross or run near the internal opening of the uterus. Vasa previa can result in rapid fetal hemorrhage occurs from the vessels tearing when the cervix dilates or membranes rupture or lack of oxygen if the vessels become pinched. Handout vasa previa from the pages of by patrick s ramsey, md, msph, and dena goffman, md vasa previa is a pregnancy complication in which blood vessels from the umbilical cord lie over the cervix, an area that the baby passes through during delivery. These vessels are within the amniotic membranes, without the support of the placenta. Vasa previa is defined as fetal vessels that run through the fetal membranes, over or near the endocervical os 2 cm or less and are unprotected by placenta or umbilical cord. Tell a friend about us, add a link to this page, or visit the webmasters page for free fun content.