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PF.58 Management and Outcome of Vasa Praevia: A Ten Year Review
  1. T Kubba,
  2. F Ushakov,
  3. S Cicero,
  4. G Attilakos
  1. Department of Fetal Medicine, UCL and UCLH Institute for Women’s Health, London, UK

Abstract

Introduction Vasa Praevia (VP) describes fetal vessels coursing through the membranes over the internal os, unprotected by placental tissue or umbilical cord. VP is associated with significant fetal risk when membrane rupture occurs. The RCOG guideline on VP recommends antenatal admission from 28–32 weeks until delivery in a unit with appropriate neonatal facilities to facilitate quicker intervention in the event of bleeding or labour.

Aim To review the management and outcome of VP cases at a tertiary teaching hospital.

Methods We undertook a ten year retrospective review (2002 to 2012) of all cases of confirmed VP. Cases were identified using the discharge codes of all inpatient episodes and the fetal medicine unit database. We reviewed the ultrasound scans and notes of all cases.

Results We identified 15 confirmed cases of VP. 14 cases were diagnosed antenatally. The median GA at diagnosis was 25+3 weeks. 9 cases were admitted antenatally (duration: 2 days to 5 weeks). None of the admitted cases went into labour.

11/15 cases had elective LSCS and 4/15 had emergency LSCS (2/4 had category 1 LSCS). The median GA at delivery was 37 + 3 weeks. The single undiagnosed case resulted in neonatal death secondary to VP.

Conclusions

  1. VP is a rare condition.

  2. A high proportion of cases were diagnosed antenatally, however there may be cases which were never diagnosed and did not cause adverse events.

  3. Further evidence is needed on the necessity and timing of antenatal admission.

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