Favoring Elective Hospitalization in Pregnancies With Vasa Previa

There is international agreement that third-trimester hospitalization is indicated for the one-third of patients with vasa previa who have risk factors for preterm birth. For the remaining two-thirds, it is controversial whether elective hospitalization or outpatient management should be recommended. There are no randomized trials comparing outcomes of the 2 strategies. Observational studies report similar outcomes with elective hospitalization and outpatient management, but are fraught with biases and are underpowered to permit a confident conclusion that outpatient management is safe. Elective hospitalization may be safer because cesarean can be performed immediately if bleeding occurs. Elective hospitalization should be the norm.