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Vasa previa: a multicenter retrospective cohort study.

Hadi Erfani1, Sina Haeri2, Scott A Shainker3

  • 1Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX.

American Journal of Obstetrics and Gynecology
|June 16, 2019
PubMed
Summary
This summary is machine-generated.

Vasa previa diagnosed antenatally has excellent outcomes. Diagnosing vasa previa before 24 weeks gestation significantly increases the chance of spontaneous resolution, improving maternal and neonatal health.

Keywords:
contemporary multicenter studyestimated gestational age at diagnosisfetal mortalitymaternal morbidityresolutionvasa previa

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Area of Science:

  • Maternal-Fetal Medicine
  • Obstetrics and Gynecology
  • Prenatal Diagnosis

Background:

  • Vasa previa is a rare but serious obstetric complication where fetal blood vessels run near the internal cervical os.
  • Antenatal diagnosis is crucial for improving outcomes, but predictive factors for resolution require further investigation.

Purpose of the Study:

  • To describe characteristics and outcomes of antenatally diagnosed vasa previa.
  • To evaluate predictive factors for spontaneous resolution of vasa previa.

Main Methods:

  • Retrospective multicenter cohort study of 136 antenatally diagnosed vasa previa cases (2011-2018).
  • Ultrasound and electronic medical records were used for identification and data abstraction.
  • Statistical analyses included descriptive statistics, ROC analysis, and logistic regression.

Main Results:

  • 14% of vasa previa cases resolved spontaneously by a median gestational age of 27 weeks.
  • Unresolved cases underwent cesarean delivery at a median gestational age of 34 weeks.
  • Diagnosis before 24 weeks gestation was associated with a significantly higher odds ratio (7.9) for resolution.

Conclusions:

  • Antenatal diagnosis of vasa previa is associated with excellent maternal and neonatal outcomes.
  • Early diagnosis (before 24 weeks) is a key predictor of spontaneous resolution.