Evaluation of Chemical Tests for Fetal Bleeding From Vasa Previa

Odunsi, Kunle; Bullough, Colin H W; Henzel, J H; Polańska, Adriana

doi:10.1097/00006254-199708000-00004

Cited by 6 publications

(7 citation statements)

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“…In the absence of prenatal diagnosis, a clinical diagnosis of vasa previa should be suspected in the setting of vaginal bleeding that occurs upon rupture of the membranes and is accompanied with fetal heart rate abnormalities, particularly a sinusoidal pattern or bradycardia [14,15,28].…”

Section: Introductionmentioning

confidence: 99%

Fetal heart rate patterns of pregnancies with vasa previa and velamentous cord insertion

Baumfeld

Gutvirtz

Shoham

et al. 2015

Arch Gynecol Obstet

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Section: Introductionmentioning

confidence: 99%

Fetal heart rate patterns of pregnancies with vasa previa and velamentous cord insertion

Baumfeld

Gutvirtz

Shoham

et al. 2015

Arch Gynecol Obstet

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“…In order to exclude or confirm fetal bleeding, various tests are available for detection of fetal hemoglobin, such as alkali denaturation tests (Apt, Ogita, Loendersloot), hemoglobin electrophoresis, and the Kleihauer-Betke test [30]. The Kleihauer-Betke test and hemoglobin electrophoresis are both reliable and sensitive, i.e., they are able to identify the presence of HbF in concentrations down to a minimum of 0.01%.…”

Section: Intrapartum Diagnosis and Confirmation Of Hbfmentioning

confidence: 99%

Guidelines for the Management of Vasa Previa

Gagnon¹,

Morin²,

Bly

et al. 2009

Intl J Gynecology & Obste

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“…The alkali denaturation tests (Ogita, Apt) are based on the principle that HbF is resistant to denaturation by alkali, unlike adult haemoglobin (HbA). These tests are reliable and fast but rather insensitive (Ogita needs 20% HbF, Apt 60%) and too complicated to perform routinely, certainly in an emergency situation [4]. Recently, a group from Sweden developed an 'easier-to-use' variation to detect HbF.…”

Section: Diagnosismentioning

confidence: 99%

Vasa praevia: a lethal threat to the fetus

Ameryckx

Amy

2006

Eur Clinics Obstet Gynaecol

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Vasa praevia constitutes a rare obstetric complication that is potentially lethal for the generally healthy infant. If unrecognized antenatally, the condition carries a higher fetal mortality rate than any other complication in pregnancy. Only in the past two decades have major diagnostic advances led to a dramatic improvement of perinatal survival and lower morbidity rates. Good outcomes depend primarily on prenatal diagnosis and appropriate management. The performance of a caesarean section before rupture of the membranes and the onset of labour is mandatory. Simple modifications of standard screening protocols and the recognition of high-risk patients will allow identification of most cases of vasa praevia. DefinitionIn normal circumstances, the umbilical cord is inserted into the chorionic plate (fetal surface) of the placenta (central or, more frequently, eccentric insertion) or on the placental edge (marginal insertion). The umbilical cord vessels course over the fetal surface before entering the placenta. In about 1% of singleton and 10% of twin pregnancies, however, the umbilical cord vessels separate from each other and start branching at a distance from the placental margin; they run through the membranes, surrounded only by a fold of amnion, before reaching the chorionic plate. If this so-called velamentous insertion is situated in the lower uterine segment, and the unprotected fetal vessels cross the region of the internal cervical os below the presenting fetal part, one speaks of vasa praevia. This aberrant vasculature can also be associated with bilobed or succenturiate placentas, in which case the vessels run between the accessory lobes.Vasa praevia is encountered rarely (1 of 2,500-5,000 deliveries), but even today they are associated with high fetal mortality (∼60%) and morbidity if undiagnosed antenatally [1]. The unprotected umbilical vessels are exposed to compression or rupture, especially during labour or at the time of rupture of the membranes. Laceration of the vasa praevia can rapidly lead to fetal exsanguination, shock (after as little as 60-ml blood loss, corresponding to 20-25% of the feto-placental blood volume) and intrauterine death. The fetus, indeed, has only a small circulatory volume of 80-100 ml/kg. The mother, on the other hand, is not at risk, in contrast to haemorrhages resulting from placenta praevia or abruptio placentae. AetiologySome placentas implant over the uterine isthmus or even over the internal cervical os. Due to the development of the lower uterine segment during the third trimester, the placenta appears to "move away" from the cervical region. The placenta preferentially grows in the better vascularised area of the corpus and may undergo atrophy in the lower parts of the uterus [2]. During this process, an aberrant vessel can persist over or close to the cervix. In cases where the placenta overlies the less vascularised internal os, it may undergo atrophy, which results in the development of a succenturiate lobe and connecting vasa praevia. Beside the aforement...

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Evaluation of Chemical Tests for Fetal Bleeding From Vasa Previa

Cited by 6 publications

References 0 publications

Fetal heart rate patterns of pregnancies with vasa previa and velamentous cord insertion

Fetal heart rate patterns of pregnancies with vasa previa and velamentous cord insertion

Guidelines for the Management of Vasa Previa

Vasa praevia: a lethal threat to the fetus

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