Treatment Outcomes after Fetoscopic Laser Ablation of Type II versus Type III Vasa Previa

Perinatal outcomes were compared for patients treated with fetoscopic laser ablation for vasa previa (VP) type II versus III. In type II VP, fetal vessels connect the main placenta to an accessory lobe, and in type III, these vessels exit and reenter a single-lobed placenta without velamentous cord insertion. Vessel ablation can be challenging in the presence of an accessory placental lobe.

This was a retrospective cohort study (2013-2025) of women with singleton pregnancies ≥31 gestational weeks who underwent laser ablation treatment for VP type II vs. III.

Of 32 study patients, 14 (43.8%) had type II and 18 (56.2%) had type III VP. All patients had successful VP occlusion (1 required a second attempt) and were managed as outpatients. Perinatal outcomes were similar for VP types. All neonates were liveborn and survived at least 30 days; 2 required hyperbilirubinemia treatment and 3 had respiratory distress syndrome. There were no cases of intraventricular hemorrhage, patent ductus arteriosus, neonatal blood transfusion, or sepsis.

For 32 VP patients treated with fetoscopic laser ablation, perinatal outcomes for types II and III VP were favorable and did not differ by VP type.