IVPF Recommendations

RISK FACTORS, TESTING AND MANAGEMENT

Specific ultrasound screening is the key to diagnosing vasa previa.

Risk Factors

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

Identification

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

Management

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.