Prenatal ultrasound diagnosis of vasa praevia and analysis of risk factors

Abstract

ObjectiveTo evaluate the role of ultrasound in prenatal diagnosis of vasa praevia (VP) and to asses the risk of VP associated with different causal factors.Material and MethodsA retrospective study of the incidence of VP in a series of 12 063 deliveries between January 2000 and March 2005. We also studied the factors that predisposed for VP and the perinatal outcome of pregnancies.ResultsThe prevalence of VP in our centre during this period was 0.07% (9 cases). All cases were prenatally diagnosed. The mean gestational age at diagnosis was 26 weeks. Multivariate analysis revealed the following associated factors: IVF pregnancies, bilobate or succenturiate placenta, and second‐trimester placenta praevia, with an odds ratio of 7.75, 22.11 and 22.86, respectively.ConclusionsIn our series, the prenatal diagnosis of all cases of VP achieved during the second‐trimester scan allowed us to avoid any prenatal death related to this condition. Copyright © 2007 John Wiley & Sons, Ltd.

Prenatal diagnosis and management of vasa previa in twin pregnancies: a case series and systematic review

“…7,14 It has been hypothesized these placental and cord anomalies could be due to the inadequate orientation of the IVF blastocyst at the time of implantation or to a higher incidence of vanishing twins in IVF than in spontaneous twins. 10,[14][15][16][17][18] The incidence of VP has been reported to be as high as one in 300 pregnancies conceived after ART. 7,14 These data suggest that the incidence of VP in both singleton and multiple pregnancy gestations is likely to increase in the next decade with the increase use of ART worldwide.…”

“…In seven cases, there was information on additional ultrasound findings including a low-lying placenta and VCI in three cases 25,26 and VCI alone in two cases. 17,28 The mean (SD) gestational at the time of diagnosis was 23+6 (7+1) weeks. Information on the mode of delivery was available in eight cases including five elective and three emergency caesarean sections, two for premature rupture of the membranes 27,28 and one for preeclampsia.…”

“…Information on the mode of delivery was available in eight cases including five elective and three emergency caesarean sections, two for premature rupture of the membranes 27,28 and one for preeclampsia. 17 The mean (SD) gestational at time of delivery was 32+6 (3+5) weeks. The neonatal outcome of the corresponding 24 fetuses including two stillbirths and two neonatal deaths.…”

Vasa praevia: ultrasound diagnosis at the mid‐trimester scan

“…However, it has been estimated that incorporating a search for vasa praevia transabdominally in the mid‐trimester scan, adds approximately 1 minute to the standard scan time 1 . When a transvaginal scan is required this will also add additional time to the length of the examination.…”

“…However, many of these figures relied on diagnosis at delivery and were calculated before the availability of transvaginal ultrasound and colour Doppler 4 . More recently, Baulies, et al 1 . reported an incidence of 1 in 1351 in a retrospective study of 12, 063 deliveries from January 2000 to March 2005.…”