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Vasa praevia
Classification and external resources
Vasaprevia.jpg
Vasa praevia
ICD-10 O69.4
ICD-9 663.5
DiseasesDB 13743
eMedicine med/3276

Vasa praevia (vasa previa AE) is an obstetric complication in which fetal blood vessels cross or run in close proximity to the external orifice of the uterus. These vessels are at risk of rupture when the supporting membranes rupture, as they are unsupported by the umbilical cord or placental tissue.[1]

Etiology/Pathophysiology[edit]

Vasa previa is present when fetal vessels traverse the fetal membranes over the internal cervical os. These vessels may be from either a velamentous insertion of the umbilical cord or may be joining an accessory (succenturiate) placental lobe to the main disk of the placenta. If these fetal vessels rupture the bleeding is from the fetoplacental circulation, and fetal exsanguination will rapidly occur, leading to fetal death.

Risk Factors[edit]

Vasa previa is seen more commonly with velamentous insertion of the umbilical cord, accessory placental lobes (succenturiate or bilobate placenta), multiple gestation, IVF pregnancy. In IVF pregnancies incidences as high as one in 300 have been reported.The reasons for this association are not clear, but disturbed orientation of the blastocyst at implantation, vanishing embryos and the increased frequency of placental morphological variations in in vitro fertilisation pregnancies have all been postulated [2]

Diagnosis[edit]

  • The classic triad of the vasa praevia is: membrane rupture, painless vaginal bleeding and fetal bradycardia.
  • This is rarely confirmed before delivery but may be suspected when antenatal sono-gram with color-flow Doppler reveals a vessel crossing the membranes over the internal cervical os.[3][4]
  • The diagnosis is usually confirmed after delivery on examination of the placenta and fetal membranes[citation needed].

Treatment[edit]

Immediate treatment with an emergency caesarean delivery is usually indicated.[5][6]

See also[edit]

References[edit]

  1. ^ Yasmine Derbala, MD; Frantisek Grochal, MD; Philippe Jeanty, MD, PhD (2007). "Vasa previa". Journal of Prenatal Medicine 2007 1 (1): 2–13. Full text
  2. ^ http://www.rcog.org.uk/files/rcog-corp/GTG27PlacentaPraeviaJanuary2011.pdf
  3. ^ Lijoi A, Brady J (2003). "Vasa previa diagnosis and management.". J Am Board Fam Pract 16 (6): 543–8. doi:10.3122/jabfm.16.6.543. PMID 14963081. Full text
  4. ^ Lee W, Lee V, Kirk J, Sloan C, Smith R, Comstock C (2000). "Vasa previa: prenatal diagnosis, natural evolution, and clinical outcome.". Obstet Gynecol 95 (4): 572–6. doi:10.1016/S0029-7844(99)00600-6. PMID 10725492. 
  5. ^ Bhide A, Thilaganathan B (2004). "Recent advances in the management of placenta previa.". Curr Opin Obstet Gynecol 16 (6): 447–51. doi:10.1097/00001703-200412000-00002. PMID 15534438. 
  6. ^ Oyelese Y, Smulian J (2006). "Placenta previa, placenta accreta, and vasa previa.". Obstet Gynecol 107 (4): 927–41. doi:10.1097/01.AOG.0000207559.15715.98. PMID 16582134. 

External links[edit]


Original courtesy of Wikipedia: http://en.wikipedia.org/wiki/Vasa_praevia — Please support Wikipedia.
This page uses Creative Commons Licensed content from Wikipedia. A portion of the proceeds from advertising on Digplanet goes to supporting Wikipedia.

3 news items

 
Exmouth Journal
Mon, 15 Sep 2014 08:11:15 -0700

Niki Cunningham, who founded the charity with husband Jamie after they lost their baby son Harry to vasa praevia in 2012, said the day had been a big success. She said: “It was really good. I was really overwhelmed by the turnout. You never know what ...

Exmouth Journal

Exmouth Journal
Wed, 27 Aug 2014 07:48:45 -0700

The prospect of national exposure is a dream come true for Niki Cunningham, who founded the trust with husband Jamie after the death of their baby Harry from vasa praevia in 2012. She said: “When we got confirmation of the acts I thought we might be ...
 
7thSpace Interactive (press release)
Wed, 10 Sep 2014 04:03:45 -0700

Vasa praevia (VP) is an obstetric condition that is associated with significant perinatal mortality and morbidity. Although the incidence of VP is low, it is one of the few causes of perinatal death that can be potentially prevented through detection ...
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