Antenatal diagnosis of vasa previa: report of three cases in an African setting

Abstract

Vasa previa is characterised by unprotected umbilical vessels that are crossing the internal cervical os or lying close to it. When vasa previa is not detected during antenatal period, the perinatal outcome could be grievous. Ultrasound is the modality of choice in detection of vasa previa. Despite the increasing availability of ultrasound in modern times, its use in diagnosing vasa previa still remain very low in Africa. We present the sonographic findings and perinatal outcomes of three cases of vasa previa which were detected antenatally within a period of nine months in an African setting.

Monochorionic Diamniotic Vasa Previa Pregnancy: A Medical Student Perspective

“…This placental abnormality is problematic because of the location of the unprotected vessels. If the fetal head compresses these vessels, it can result in fetal hypoperfusion and acidemia [ 6 ]. Vessel rupture will lead to fetal hemorrhage, and therefore, early diagnosis is critical, highlighting the importance of ultrasound [ 7 ].…”

Timing of birth and adverse pregnancy outcomes in cases of prenatally diagnosed vasa previa: a systematic review and meta-analysis

“…Three studies were excluded from the quantitative synthesis as they had a study sample less than five. [27][28][29] Of the remaining 34 studies, four presented a data breakdown by gestational age. 1,18,19,30 The remaining 30 studies only reported the total incidence of complications across all deliveries, and did not specify the gestational age that they occurred at.…”

“…The most commonly reported outcomes included perinatal mortality, 4,7,[12][13][14]18,19,[27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][45][46][47][48][49][50][51][52] respiratory distress syndrome (RDS) requiring intubation, 12,14,27,30,33,34,[36][37][38]40,41,46 5-minute Apgar scores <7, 1,2,12,14,18,19,[27]…”

“…The most common recommendations were 34 to 35 weeks 30,33,42 and 35 weeks. 7,12,29 Only one study suggested delivery earlier than this at 33 to 34 weeks. 17 Broader recommendations included 34 to 36 weeks, 46 34 to 37 weeks, 20 and 35 to 37 weeks.…”

“…[18][19][20] Half of the 14 studies recommended delivery at 35 weeks or earlier. 7,12,17,29,30,33,42 One study recommended 36 weeks. 32 The remaining studies proposed a window of time that extended to at least 36 weeks, but also included gestations at 35 weeks or prior.…”