RISK FACTORS, TESTING AND MANAGEMENT
Specific ultrasound screening is the key to diagnosing vasa previa.
- Low-lying placenta or placenta previa in the second trimester (even if this resolves)
- Bilobed or succenturiate-lobed placenta
- Velamentous insertion of the cord
- In-vitro fertilization pregnancies
- Multiple-fetal pregnancies
- History of uterine surgery or D&C
- Transvaginal color Doppler ultrasound for women with above risk factors
- Identification of umbilical cord placental insertion during all routine obstetrical ultrasounds
- If vasa previa is suspected in second trimester scan then repeat ultrasound in third trimester to confirm diagnosis of vasa previa and position of fetal vessels
- Pelvic rest
- Hospitalization in the 3rd trimester in a tertiary level hospital with neonatal intensive care unit and 24hour operating theatres available
- Delivery by caesarean section at approximately 35-36 weeks (earlier if indicated)
- Administration of corticosteroids for fetal lung maturation
- Immediate blood transfusion and aggressive resuscitation of the infant in the event of a rupture
All cases of vasa previa are different and any management plan should be developed in partnership between the mother and her doctors based on her own individual circumstances. The management recommendations provided by the IVPF are general recommendations only and can be used as the starting point for the development of an individual management plan. The IVPF does not provide medical advice and it is important that if you are diagnosed with vasa previa you consult with an appropriately qualified medical practitioner.
The International Vasa Previa Foundation believes
that infant death due to vasa previa is an avoidable tragedy. IVPF recommendations are based on the consolidated results of science,
technology, and its experience with hundreds of vasa previa families. Infant death and injury can be prevented when vasa previa is
prenatally diagnosed and Cesarean section is performed at 35-36 weeks.