Vasa Praevia: a descriptive review of existing literature and the evolving role of ultrasound in prenatal screening

Donnolley, Natasha; Halliday, Lesley E.; Oyelese, Yinka

doi:10.1002/j.2205-0140.2013.tb00168.x

Cited by 6 publications

(6 citation statements)

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“…The exposed fetal vessels are in danger of rupture in late pregnancy or in labour, carrying a high risk of death of the baby. Although the incidence of VP has been estimated to be 1 in 2500 births [ 3 ], it is potentially under reported [ 4 , 5 ]. The incidence of VP in IVF pregnancies is reported to be 1 in 202- 293 births [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

"Wrapping myself in cotton wool": Australian women's experience of being diagnosed with vasa praevia

Javid

Sullivan

Halliday

et al. 2014

BMC Pregnancy Childbirth

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BackgroundVasa praevia (VP) is an obstetric condition that is associated with significant perinatal mortality and morbidity. Although the incidence of VP is low, it is one of the few causes of perinatal death that can be potentially prevented through detection and appropriate care. The experience of women diagnosed with or suspected to have VP is largely unknown. The aim of this study was to explore the experiences and impact that a diagnosis or suspected diagnosis of VP had on a group of Australian women.MethodA qualitative study using a descriptive exploratory design was conducted and Australian women diagnosed with VP were recruited via online methods in 2012. An inductive approach was undertaken and interviews were analysed using the stages of thematic analysis.ResultsOf the 14 women interviewed, 11 were diagnosed with VP during pregnancy with 5 subsequently found not to have VP (non-confirmed diagnosis). Three women were diagnosed during childbirth with one neonatal death. Five major themes were identified: feeling like a ticking time bomb; getting diagnosis right; being taken seriously; coping with inconsistent information; and, just a massive relief when it was all over.ConclusionsThis is the first study to describe women’s experience of being diagnosed with or suspected to have VP. The findings from this research reveal the dilemmas these women face even if their baby is ultimately born healthy. Their need for clear and consistent information, sensitive care, support and continuity is evident. Clinicians can use these findings in developing information, counselling and models of care for these women.

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Section: Introductionmentioning

confidence: 99%

"Wrapping myself in cotton wool": Australian women's experience of being diagnosed with vasa praevia

Javid

Sullivan

Halliday

et al. 2014

BMC Pregnancy Childbirth

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“…If this pathology is diagnosed before the onset of clinical signs and upon the scheduled completion of pregnancy, the neonatal survival rate is 96-97% (1,5,10,15). The optimum time for the completion of pregnancy has not been established (5).…”

Section: Literature Review and Discussionmentioning

confidence: 99%

Vasa praevia: a case report and literature review

Norvilaitė

Peštenytė

Bužinskienė

et al. 2016

AML

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Background. The aim of this article is to present a rare clinical case of vasa praevia as well as to assess the relevance of the problem by reviewing the latest literature sources.Materials and methods. In this report we present a case of a 33-yearold woman diagnosed with vasa praevia at 33 weeks of pregnancy, after hospitalisation with preterm rupture of membranes following the delivery of a live healthy baby through a lower segment Caesarean section during 33rd week of gestation at Vilnius University Hospital Santariškių Clinics. We investigated all the documentation of the patient before and after delivery.Results and conclusions. Vasa praevia is a rather rare pathology which is likely to occur during pregnancy, may result in heavy bleeding and be particularly threatening to the fetus life. A timely diagnosis for these women is essential. The gold standard for vasa praevia diagnosis is the fetal ultrasound scan. Vasa praevia pathology is found during the routine second trimester ultrasound check-up. The selection of proper tactics applied during pregnancy care is essential. At the gestational age of 28-32, it is advisable to mature fetal lungs as well as the fetus condition should be investigated by a perinatologist. The mode of delivery is the C-section which tends to reduce the frequency of possible complications.

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“…In two studies the natural progression of vasa praevia was also examined through serial scans to assess the resolution of the condition through gestations. 15,16 The resolution of vasa praevia was seen in three of 18 1 5 cases and five of 32 1 6 cases showing the need for serial scans after diagnosis. Further to this, Rebarber et al.…”

Section: Reviewmentioning

confidence: 96%

“…3 If undetected the associated fetal mortality rate is 44% whereas if antenatally detected, the fetal survival rate is noted as 97%. 4 The condition is rare with reported incidence rates in the literature varying between one in 2500 5 to one in 6000. 4 However, the incidence rates may be underreported due to the difficulty in prenatal diagnosis and the inability to accurately diagnose once delivered.…”

Section: Introductionmentioning

confidence: 99%

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Is ultrasound screening for vasa praevia clinically justified and a financially viable screening test? A literature review

Gillian

Venables

2018

Ultrasound

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Vasa praevia is an obstetric complication currently not screened for within the United Kingdom, which if undetected prenatally can lead to fetal death when the membranes rupture. Internationally, guidelines are available providing guidance on the best screening policy and management pathways. However, the UK National Screening Committee and Royal College of Obstetricians and Gynaecologists do not support screening due to a lack of evidence. Recent studies explore the ability of ultrasound to detect vasa praevia prenatally in both the general and high-risk populations. Whilst there is no consensus on the 'best' screening strategy, the majority of authors note that targeted screening of the high-risk population is the most achievable and cost-effective strategy. Although not infallible, a standard screening protocol could identify the majority of cases in the high-risk group. Introduction of a screening strategy would affect training needs of professionals within the UK and would have implications on the need to produce guidelines on management and quality assurance. Further research is also needed to define a relevant high-risk population and explore how this would impact on service provision. This review explores the current evidence base for systematic screening and the implications for service.

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Vasa Praevia: a descriptive review of existing literature and the evolving role of ultrasound in prenatal screening

Cited by 6 publications

References 64 publications

"Wrapping myself in cotton wool": Australian women's experience of being diagnosed with vasa praevia

"Wrapping myself in cotton wool": Australian women's experience of being diagnosed with vasa praevia

Vasa praevia: a case report and literature review

Is ultrasound screening for vasa praevia clinically justified and a financially viable screening test? A literature review

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