Ultrasound-guided caesarean section as a safer intraoperative strategy for vasa previa type III: A case report

Vasa previa refers to the presence of chorionic vessels (arterial or venous) unprotected by Wharton's jelly, traversing the membranes over or near the internal cervical orifice. If diagnosed prenatally, the condition has a survival rate of up to 97 %. Ultrasound has proven to be a useful diagnostic tool, although its use for general population screening remains a topic of debate. In addition to its diagnostic applications, ultrasound may serve as a valuable intraoperative aid during complex caesarean sections, particularly in high-risk cases such as pregnancies complicated by vasa previa, by contributing to safer and more precise surgical management. The present report concerns a case of type III vasa previa in a patient with three previous caesarean sections, where mapping of the fetal vessels was challenging due to the cephalic presentation during labor. During the caesarean section, ultrasound evaluation of the anterior uterine wall allowed the surgeon to select the best approach for the hysterotomy. Standardizing the intraoperative transuterine ultrasound approach could provide valuable guidance in selecting the most appropriate uterine incision, thereby enhancing surgical safety and promoting both maternal and fetal well-being.