Introduction RCOG have recently published guidelines regarding vasa praevia. Routine screening is not recommended but additional ultrasonography is advised if vasa praevia is suspected from previous ultrasound scans or clinical suspicion. Elective caesarean section is recommended before the onset of labour between 35 and 37 weeks.
Aim To determine the outcome of cases of vasa praevia at St Michael's Hospital, Bristol and compare management to the new guidelines.
Methods We used the discharge codes of all inpatient episodes to identify cases of vasa praevia between 2000 and 2010 at St Michael's Hospital, Bristol. We also searched the perinatal mortality database to identify vasa praevia-related deaths. We collected demographic data, as well as data relating to diagnosis, management and delivery.
Results We identified 18 cases of vasa praevia without any perinatal deaths due to vasa praevia in this time period. 5/18 cases were diagnosed antenatally, with the remaining diagnosed intrapartum. All women diagnosed antenatally had a low-lying placenta throughout pregnancy and had repeat ultrasound scans. Gestational age at delivery was 36.3±1.1 weeks in the antenatal diagnosis group compared to 38.9±1.8 weeks in the intrapartum diagnosis group. All cases diagnosed antenatally were delivered by elective caesarean section.
Conclusions Despite RCOG guidelines only recently being published, all women diagnosed antenatally had the recommended repeat ultrasound scans and were managed as guidelines suggest. Despite the intrapartum diagnosis of most cases, the perinatal mortality was surprisingly low. As the total number of cases is too small, multicentre observational studies may provide more meaningful conclusions.
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