Vasa previa: Perinatal outcomes in singleton and multiple pregnancies.

Area of Science:

• Maternal-Fetal Medicine
• Obstetrics
• Neonatology

Background:

• Vasa previa (VP) is a rare but critical obstetric condition with high fetal risks.
• Existing literature highlights the association between VP and increased perinatal mortality.
• Understanding outcomes in singleton versus multiple gestations is crucial for management.

Purpose of the Study:

• To retrospectively analyze perinatal outcomes of vasa previa in singleton and multiple pregnancies.
• To compare outcomes based on prenatal diagnosis versus diagnosis at delivery.
• To evaluate optimal timing for delivery in singleton and twin pregnancies with VP.

Main Methods:

• Retrospective analysis of 157 vasa previa cases (2013-2019) at a tertiary hospital.
• Inclusion of singleton, twin, and triplet pregnancies.
• Comparison of perinatal outcomes stratified by prenatal diagnosis and plurality.

Main Results:

• Neonatal mortality was significantly higher in cases diagnosed at delivery (9.7%) versus prenatally (1.3%).
• Prenatal diagnosis correlated with higher NICU admission, prematurity, and neonatal pneumonia rates.
• Twin pregnancies with VP diagnosed prenatally had earlier admission and delivery ages, and higher neonatal mortality than singletons.

Conclusions:

• Prenatal diagnosis of vasa previa is associated with improved neonatal survival.
• Early hospitalization in the third trimester is recommended for VP.
• Suggested optimal delivery windows are 34-36 weeks for singletons and 32-34 weeks for twins, with individualized adjustments.