Benckiser's hemorrhage: about an uncommon case report

Area of Science:

• Obstetrics and Gynecology
• Fetal Medicine
• Perinatology

Background:

• Vasa previa involves rupture of umbilical vessels with velamentous insertion, a critical obstetric emergency.
• This condition leads to rapid fetal exsanguination and has a high neonatal mortality rate (75-100%).
• Hemorrhage typically occurs upon membrane rupture, necessitating prompt intervention.

Purpose of the Study:

• To highlight the importance of prenatal diagnosis of vasa previa.
• To emphasize the benefits of prophylactic cesarean section in preventing fetal demise.
• To present a case illustrating the diagnostic and management challenges.

Main Methods:

• Case report of a 27-year-old patient presenting at 32 weeks gestation with labor-like pain and vaginal bleeding.
• Emergency cesarean section performed due to suspected retroplacental hematoma.
• Post-cesarean placental examination confirmed diagnosis of torn velamentous vessels.

Main Results:

• The newborn required immediate resuscitation and NICU admission for blood transfusions.
• Prenatal diagnosis via ultrasound can identify vasa previa, enabling prophylactic measures.
• Timely intervention significantly reduces risks associated with vasa previa rupture.

Conclusions:

• Detailed prenatal ultrasonography screening for vasa previa in high-risk pregnancies is essential.
• Elective cesarean section around 35 weeks of gestation prevents membrane rupture and fetal exsanguination.
• Management must balance preventing fetal demise with the risks of iatrogenic prematurity.