Vasa Previa

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• Vasa Previa
• Information provided by
• theInternational Vasa Previa Foundation

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What is Vasa Previa?

• Vasa previa is a rarely reported condition
  (12,500 births) in which fetal blood vessels
  from the placenta or umbilical cord cross the
  entrance to the birth canal, beneath the baby.

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Vasa Previa
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Two Forms of Vasa Previa

• Velamentous insertion of the umbilical cord
• Normal cord insertion with vessels running
  between placental lobes in a bi-lobed or
  succenturiate (accessory) lobed placenta

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Velamentous Cord Insertion

• Velamentous insertion means that the fetal
  vessels, unprotected by Whartons jelly, traverse
  the membranes before they come together into the
  umbilical cord. 

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Bilobed Placenta

• A bilobed placenta consists of two parts of
  the placenta. Vasa previa may result from vessels
  running in the membranes between the two lobes.

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Succenturiate Lobed Placenta

• A succenturiate (accessory) lobe is a second
  or third placental lobe that is much smaller than
  the largest lobe.

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Risk Factors

• The International Vasa Previa Foundation
  (IVPF) believes that women with the following
  conditions are at risk and should be investigated
  with transvaginal color Doppler ultrasound

• Low lying placenta or placenta previa
• Velamentous cord insertion
• Bilobed or succenturiate lobed placenta
• Multiple pregnancies
• In vitro fertilization (IVF) pregnancies
• History of uterine surgery or D C
• Painless bleeding

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Routine Ultrasound

• The IVPF believes that any woman with the
  previous conditions should be thoroughly scanned
  with transvaginal color Doppler ultrasound for
  the presence of aberrant vessels near the
  internal os.
• The IVPF also supports making color Doppler
  scanning of the placental end of the cord a
  standard part of the protocol during all routine
  obstetrical ultrasounds.

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Management ofDiagnosed Vasa Previa

• Bedrest
• Hospital admission in the third trimester
• Steroid injections to promote fetal lung
  maturation
• Elective Cesarean section at 35 weeks

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How to Diagnose Vasa Previa

• Vasa previa can be diagnosed by using
  transvaginal color Doppler ultrasound.

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What to Do When Vasa Previa Is Suspected after a
Bleed

• Emergency C-section
• Aggressive resuscitation of the baby with blood
  transfusion following delivery
• Ogita blood testing to determine origin of blood
  loss (maternal or fetal) for abnormally heavy
  bloody shows or bleeds that are not considered
  life threatening when the fetus is not in distress

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International Vasa Previa Foundation

• The International Vasa Previa Foundation agrees
  that vasa previa can, but should not, be a
  devastating complication of pregnancy.
• The goals of the IVPF are to raise awareness
  about vasa previa and seek to adjust the medical
  rules and protocols worldwide such that fatal
  outcomes associated with vasa previa can be
  prevented.

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• It only takes a moment
• to diagnose life

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