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

Vasa praevia (vasa previa AE) is an obstetric complication in which fetal blood vessels cross or run near 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[citation needed]. 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[citation needed].

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.[2][3]
  • The diagnosis is usually confirmed after delivery on examination of the placenta and fetal membranes[citation needed].
  • Alkali denaturation test detects the presence of fetal hemoglobin in vaginal blood, as fetal hemoglobin is resistant to denaturation in presence of 1% NaOH.
  • Also detection of fetal hemoglobin in vaginal bleeding is diagnostic.

Treatment[edit]

Immediate treatment with an emergency caesarean delivery is usually indicated.[4][5]

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. ^ 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
  3. ^ 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. 
  4. ^ 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. 
  5. ^ 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. 

7. Textbook of Obstetrics by D.C. Dutta 7th edition, page 259

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.
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39 news items

 
The Australian
Sun, 19 Jul 2015 00:22:55 -0700

A mother had a rare complication — vasa praevia, affecting about one in 5000 pregnancies — which can lead to life-threatening bleeding. She contacted Melinda Cruz, co-founder of the Miracle Babies Foundation, to ask if other parents had experienced ...

BBC News

BBC News
Sat, 15 Mar 2014 09:30:00 -0700

A post mortem examination revealed the cause of death was vasa praevia - a rare condition that affects one in about 2,500 births in the UK. The condition affects 555 babies a year in the UK. Charity Vasa Praevia Raising Awareness says that the survival ...
 
Sky News
Thu, 22 Nov 2012 18:22:31 -0800

The condition is called vasa praevia. Blood vessels in the placenta grow abnormally and can rupture when a woman's waters break or the baby starts to move down the birth canal. At least one baby is affected by the condition every day in the UK. Women ...
 
Daily Mail
Mon, 19 Nov 2012 14:50:00 -0800

In vasa praevia, either the umbilical cord does not grow into the middle of the placenta as it should, but attaches around the edge of the placenta, leaving the blood vessels exposed; or the placenta develops in two parts and the blood vessels grow to ...

Hertfordshire Mercury

Hertfordshire Mercury
Mon, 26 Jan 2015 23:18:14 -0800

Campaigners point out that when the condition is diagnosed antenatally through an ultrasound scan, the survival rate is 100 per cent – the charity Vasa Praevia Raising Awareness have no records of babies dying once it has been diagnosed prior to birth.

Closer

Closer
Tue, 26 May 2015 06:52:30 -0700

Vasa praevia. This is a rare condition, in which your baby's blood vessels run through the membranes covering the cervix, rather than remaining protected within the umbilical cord and placenta. When your waters break, these vessels may be torn and ...

Bristol Post

Bristol Post
Fri, 03 Oct 2014 00:41:15 -0700

Christina said: "It hits women regardless of age or race and there are certain factors that can increase the risk but unless you are aware of Vasa praevia and ask to be tested the NHS will ignore it. This needs to change. I know how it feels to be told ...

Wigan Today

Wigan Today
Sat, 29 Nov 2014 01:56:15 -0800

The former Hear'Say singer was also a special guest at a ball in Exeter for The Harry Cunningham Trust, created in honour of Harry who died in 2012, aged 26 weeks of vasa praevia - a fatal condition which affects premature babies. Since Kym lost her ...
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