Vasa previa is a rare pregnancy complication where fetal blood vessels cross the birth canal, causing deprivation of oxygen or bleeding out. Risk factors include placental abnormalities and multiple pregnancies. Screening with transvaginal Doppler ultrasound can identify the condition, and a cesarean section is the treatment. Women should receive prenatal care and inform their obstetricians of their medical history.
Vasa previa is a rare pregnancy complication in which blood vessels that supply oxygen and nutrients to the developing fetus cross between the fetus and the opening to the birth canal. During pregnancy, this complication may not cause any problems. However, once the amniotic sac ruptures and the mother goes into labor, these blood vessels can be pinched or torn, causing the baby to be deprived of oxygen or bleed out. This condition can be fatal if not identified in time; mortality rates for children with vasa previa can approach 90%.
There are several risk factors that can lead to vasa previa. The first is placental abnormalities, such as a bilobed placenta or a placenta that is unusually low. Women who have had multiple pregnancies are at greater risk of having babies with the condition, and it can also be a complication of IVF. Vasa previa rarely occurs in cases where these risk factors are not present, which some doctors argue is strong evidence to screen all women with these risk factors.
Screening for vasa previa before birth can be done with the use of transvaginal Doppler ultrasound, which can be used to map blood vessels and identify unusual blood vessel arrangements. The fragile, unsupported blood vessels characteristic of vasa previa can also rupture during pregnancy, causing painless vaginal bleeding which can be a warning sign of a complication.
The treatment for this pregnancy complication is a cesarean section to deliver the baby before the amniotic sac ruptures. This should be scheduled close enough to the due date to limit the risks associated with premature birth, but not so close that a woman could spontaneously go into labor before her scheduled surgery. If this condition isn’t identified until a woman goes into labor, an emergency C-section is needed to get the baby out before she or he goes into trouble.
This pregnancy complication is nobody’s fault. Women cannot avoid risk factors for vasa previa; all they can do is be aware of the risk. Receiving extensive prenatal care and preventive screenings can help women identify pregnancy complications early so plans can be made to address them. Women should make sure their obstetricians know their complete medical history so that any risk factors that could complicate pregnancy are known in advance.
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