VASA PREVIA!Clinical Presentations, Outcomes

and Implications

Purpose

Evaluate patients with diagnosis of vasa previa and assess outcomes in order to develop recommendations

Increased risk of Vasa previa

K.B.

32yo G3P2002 with Di-Di twins and h/o 2 prior c/s

Twin A initially noted to have velamentous CI, no vasa previa at 20wga

Presented with VB at 25w5d. Developed/Identified as placenta previa with

velamentous CI and vasa previa at 25w6 d/c’ed, returned with 2nd bleed at 26w3d,

signed out AMA HD#8 Presented in labor at 32w2d, 2-3cm visually

dilated with bulging membranes

Pathologic Diagnosis :

A. Twin placenta:-Third trimester dichorionic diamniotic twin placenta: -Twin #1 placenta showing intervillous hemorrhage, acute chorioamnionitisand velamentous insertion of cord. -Twin #2 placenta showing velamentous insertion of cord.

J.B.:

20w US : complete previa with marginal cord insertion

Progressed to marginal placenta previa with velamentous cord insertion and vasa previa

Plan to admit at 32wga (tomorrow) Plan for delivery at 34wga

JB: marginal placenta, velamentous cord insertion

K.S.

33yo G1P0 with anterior placenta, posterior succenturate lobe, marginal placenta previa, vasa previa.

Admitted at 32wga for surveillance Plan for delivery between 34 and 35 wga

K.D.

41yo G1P0 with vasa previa, low lying placenta, marginal, possible velamentous C

Admit at 32w2d Scheduled delivery at 34 WGA