Management of vasa previa during pregnancy

In order to prevent fetal mortality due to vasa previa, it is necessary to obtain an antenatal diagnosis and perform elective cesarean section prior to membrane rupture. Under present circumstances, management strategies for vasa previa depend on each institutional policy. In our institution, patients are not routinely admitted, although precise outpatient management, including confirming the presence of uterine contractions and monitoring the cervical length, fetal growth and fetal heart rate, is provided for pregnant females with vasa previa. In the present report, we reviewed 21 cases of vasa previa managed at our hospital. Some 71% (15/21) of them were required inpatient management due to its complications, resulting in emergency delivery in about half of them. Therefore, our results suggest that only carefully selected asymptomatic patients may be successfully managed as outpatients.