Vasa praevia: another cause for concern in in vitro fertilization pregnancies

A case is reported of the velamentous insertion of the umbilical cord into the membranes of the placenta, unsuspected until delivery, in an in vitro fertilization pregnancy. Abnormal placental development adds a new dimension of risk to these pregnancies. The Australian Register of in vitro fertilization (IVF) pregnancies has shown (1) an increase in perinatal mortality rates but there are many possible causes for such an increase. A recent report (2) has suggested a higher incidence of velamentous and marginal insertions of the umbilical cord in IVF pregnancies. We wish to report a case of marked velamentous insertion of the cord which was associated with an uncomplicated vaginal delivery, but highlights the possible increased risks of vasa praevia in IVF pregnancies.