In vasa previa, fetal blood vessels, as opposed to maternal blood vessels, are present in the membranes covering the cervix, which is the opening to the uterus. The baby comes through the cervix once the opening is completely open. The prevalence of vasa previa is approximately 1 in 2500 deliveries but is much higher in pregnancies conceived following use of assisted reproductive technologies such as in vitro fertilization (prevalence as high as 1 in 202). The prevalence is also increased in second-trimester low-lying placentas or placenta previa, in which the placenta is covering the cervix (even if resolved), bilobed or succenturiate lobe placentas (other placental abnormalities) in the lower uterine segment, and multiple gestations. During Vasa Previa, blood vessels from the umbilical cord lie over the cervix. The baby will pass through the cervix during delivery, making early detection and monitoring key. When unprotected blood vessels are over the cervix, there is a greater risk to the baby due to the possibility of a tear in the fetal blood vessels particularly after a patients membranes rupture causing the baby to bleed heavily which can lead to serious complications including death. However, with early detections and proper observation, the risk of pregnancy loss is less than 5%. For information on the history of Vasa Previa, contact us today!
How is Vasa Previa Diagnosed?
Vasa Previa is typically diagnosed during an ultrasound. If Vasa Previa is present, the ultrasound will show a feta blood vessel either directly above or close next to the cervix. If this is found, your doctor will most likely recommend additional ultrasounds as well as vaginal ultrasounds during the second or third trimester. In approximately 20%-25% of vasa previa cases, when suspected early in pregnancy the condition can actually resolve itself.
How to Manage a Pregnancy with Vasa Previa?
When an expecting mother is diagnosed with vasa previa, the goal is to extend pregnancy as close to term as safely as possible. In order to avoid complications, pelvic rest is often recommended. Pelvic rest would involve avoiding inserting anything into the vagina and refraining from intercourse. Steroids may be used to help the baby during this time. If early delivery occurs or is recommended, you may be admitted to the hospital early for close monitoring and quicker delivery.
How Does Vasa Previa Affect Delivery?
Once the presence of vasa previa is established, you and your doctor will often plan for a cesarean birth at a hospital that is capable of caring for your baby under this condition. With a cesarean birth, your doctor can adjust the location of the incision to work around the placenta and blood vessels. If one of the blood vessels is torn, your doctor can quickly clamp the umbilical cord to avoid blood loss. When this condition is detected early on, the ability for your doctor to plan and balance the risks of early delivery and risks of labor the survival rates for infants is over 90%. Many experts feel that a cesarean birth between 34 and 37 weeks (late preterm birth) often provides the healthiest result for mothers and babies. For more information, visit our blog page or contact us today!
Maternal Fetal Medicine blogs are intended for educational purposes only and do not replace certified professional care. Medical conditions vary and change frequently. Please ask your doctor any questions you may have regarding your condition to receive a proper diagnosis or risk analysis. Thank you!