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Obstetric Complications

Question
74 out of 80
 

True about Vasa previa. (AIIMS MAY. 2009)



A Risk factor is low Lying placenta in second trimester

B Management is Caesarian section at 38 weeks

C Incidence is 1 in 1500

D Un diagnosed vasa previa carries a perinatal mortality of 20%

Ans. B

Management is Caesarian section at 38 weeks

Vasa Previa

1. Vasa previa is a rarely (1:2500)(option c) reported condition in which fetal blood vessel(s) from the placenta or umbilical cord crosses the entrance to the birth canal, beneath the baby.

2. The condition has a high fetal mortality rate (50-95%)(opion d). This can be attributed to rapid fetal exsanguination resulting from the vessels tearing.

3. Vasa previa might be present if any of the following conditions exist:

a. Velamentous cord insertion

b. Bilobed placenta

c. Succenturiate-lobed placenta

d. Low-lying placenta or placenta previa

e. Pregnancies resulting from in-vitro fertilization

f. Multiple pregnancies

g. Maternal history of D&C or uterine surgery

Management

a. When vasa previa is detected prior to labor, the baby has a much greater chance of surviving. Survival rates can range from 50 -95%,

b. Vasa previa can be detected during pregnancy with use of transvaginal sonography, preferably in combination with color Doppler. Women with the above risk factors should have this test to rule out vasa previa.

c. When vasa previa is diagnosed, elective delivery by caesarean (37-38 weeks) before labor begins can save the baby's life. Ideally, it should be performed early enough to avoid an emergency, but late enough to avoid problems associated with prematurity.

Obstetric Complications Flashcard List

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