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Term vaginal delivery following fetoscopic laser photocoagulation of type II vasa previa

R Johnston1, V K Shrivastava, R H Chmait

  • 1Department of Obstetrics and Gynecology, UC Irvine Medical Center, Orange, Calif., USA.

Fetal Diagnosis and Therapy
|November 20, 2013
PubMed

Unrecognized vasa previa carries a significant risk of fetal mortality. Advances in ultrasound have improved detection of vasa previa and led to a dramatic reduction in fetal morbidity and mortality. However, current management strategies require prolonged hospitalized surveillance, preterm delivery prior to the onset of labor or rupture of membranes, and a cesarean delivery. Fetoscopic laser ablation of type II vasa previa allows for the possibility of term vaginal delivery. We present a patient who underwent successful laser photocoagulation of a type II vasa previa at 32(5)/7 weeks' gestation. She subsequently delivered vaginally at term without complications. The potential benefits of definitive in utero treatment of non-type I vasa previa, such as vaginal delivery at term, must be weighed against the procedure-related risks of operative fetoscopy.

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