Vasa Previa Treatment and diagnosis to avoid Stillbirth

 

RCOG Guidelines: Vasa Praevia Diagnosis and Management

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Intrauterine Fetal Demise

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RCOG Guideline The Prevention of Malaria in Pregnancy No. 54a

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RCOG Guideline, Vasa Praevia

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RCOG Guideline The diagnosis and treatment of malaria in pregnancy No. 54b

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Vasa previa

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How best to diagnose and treat the small for gestational age fetus

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Vasa Previa Diagnosis and Treatment to Prevent Stillbirth Risk Factors and Causes of Vasa Previa. Normally, the blood vessels of the umbilical cord and the placenta are insulated Symptoms of Vasa Previa. Vasa previa does not always cause symptoms. When it does, the main symptom is the sudden.

In vasa previa, membranes that contain blood vessels connecting the umbilical cord and placenta lie across or near the opening of the cervix—the entrance to the birth canal. Pregnancy complications, such as vasa previa, are problems that occur only during pregnancy. They may affect the woman, the.

Overall, vasa praevia is associated with an increased risk of preterm birth. The associated complications of prematurity are in many cases the result of iatrogenic preterm birth in an effort to prevent stillbirth. Gestational age at delivery is the only other variable associated with perinatal outcomes in the management of vasa praevia. Vasa previa refers to unprotected fetal vessels running through the membranes over the cervix under the presenting part.

1 First described by Lobstein 2 in 1801, this condition is of great importance because rupture of these vessels may result in fetal death or severe perinatal morbidity. 1-10 Until the advent of antenatal diagnosis, vasa previa carried an extremely high rate of perinatal. Women were included if they were diagnosed with vasa previa during pregnancy orchildbirth, confirmed by clinical examination or placental pathology. The mainoutcome measures included stillbirth, neonatal death, cesarean delivery, andpreterm birth. RESULTS: Sixty-three women had a confirmed diagnosis of vasa previa.

Diagnosis and management of vasa previa. Vasa previa occurs when unprotected fetal blood vessels run through the amniotic membranes and traverse the cervix. Complications include fetal hemorrhage, exsanguination, or death. Diagnosis by ultrasound. Management: antenatal corticosteroids 28-32 weeks, considerations for preterm hospitalization at 30-34 weeks, and delivery at 34-37 weeks.

Vasa previa can occur even in cases without placental malposition and the precise diagnosis of vasa previa, and the course of the cord vessels contributes to a safe delivery. Vasa previa might be present if any of the following conditions exist: low-lying placenta (may be caused by previous miscarriages followed by curreting of the uterus (D&C) or uterine surgeries, which can cause scarring in the uterus), bilobed or succenturiate-lobed placentas, velamentous insertion of the cord, pregnancies resulting from in-vitro fertilization or multiple pregnancies. (5-6) Vasa previa bleeding is. Suspect vasa previa based on symptoms and (painless vaginal bleeding, rupture of membranes, fetal bradycardia) and/or findings during routine prenatal ultrasonography. Use transvaginal ultrasonography to confirm vasa previa and to distinguish it (fixed umbilical cord) from funic presentation (movable cord).

Vasa Previa. Test your knowledge. Uterine Fibroids.

Which of the following should be given to prevent the adverse effects of long-term gonadotropin-releasing hormone (GnRH) agonist use in the treatment of uterine fibroids? Danazol The diagnosis of stillbirth is clinical.

List of related literature:

Vasa previa is managed with immediate cesarean section if diagnosed during labor and with planned cesarean section if diagnosed antenatally.

“Conn's Current Therapy 2019” by Rick D. Kellerman, David Rakel
from Conn’s Current Therapy 2019
by Rick D. Kellerman, David Rakel
Elsevier Health Sciences, 2018

MANAGEMENT When diagnosed antenatally, vasa previa should be managed similarly to placenta previa.

“Obstetrics: Normal and Problem Pregnancies E-Book” by Steven G. Gabbe, Jennifer R. Niebyl, Henry L Galan, Eric R. M. Jauniaux, Mark B Landon, Joe Leigh Simpson, Deborah A Driscoll
from Obstetrics: Normal and Problem Pregnancies E-Book
by Steven G. Gabbe, Jennifer R. Niebyl, et. al.
Elsevier Health Sciences, 2016

Vasa previa is managed with immediate cesarean section if diagnosed during labor and with a planned cesarean section if diagnosed antenatally.

“Conn's Current Therapy 2020, E-Book” by Rick D. Kellerman, KUSM-W Medical Practice Association, David Rakel
from Conn’s Current Therapy 2020, E-Book
by Rick D. Kellerman, KUSM-W Medical Practice Association, David Rakel
Elsevier Health Sciences, 2019

If vasa previa is diagnosed, the patient is usually placed on bed rest awaiting cesarean section.

“Fundamentals of Emergency Ultrasound” by John P. McGahan, Michael A Schick, Lisa Mills
from Fundamentals of Emergency Ultrasound
by John P. McGahan, Michael A Schick, Lisa Mills
Elsevier Health Sciences, 2019

To prevent massive maternal blood loss during a vaginal delivery, D & E is the procedure of choice for second-trimester fetal demise with placenta previa.

“Chestnut's Obstetric Anesthesia E-Book” by David H. Chestnut, Cynthia A Wong, Lawrence C Tsen, Warwick D Ngan Kee, Yaakov Beilin, Jill Mhyre, Brian T. Bateman, Naveen Nathan
from Chestnut’s Obstetric Anesthesia E-Book
by David H. Chestnut, Cynthia A Wong, et. al.
Elsevier Health Sciences, 2019

(d) Vasa previa may be diagnosed by: [i] Vaginal examination [ii] Amnioscopy [iii] Palpation of a vessel pulsating synchronously with the FHR in the membranes in front of the fetus [iv] Cesarean delivery may be indicated if the health care provider believes the risk of hemorrhage to be great.

“Core Curriculum for Maternal-Newborn Nursing E-Book” by AWHONN, Susan Mattson, Judy E. Smith
from Core Curriculum for Maternal-Newborn Nursing E-Book
by AWHONN, Susan Mattson, Judy E. Smith
Elsevier Health Sciences, 2010

Our management strategy once vasa previa has been diagnosed is performed by a maternal fetal medicine specialist and includes several steps.

“Bleeding During Pregnancy: A Comprehensive Guide” by Eyal K. Sheiner
from Bleeding During Pregnancy: A Comprehensive Guide
by Eyal K. Sheiner
Springer New York, 2011

Treatment of placenta previa depends on the gestational age and the extent of bleeding.

“Manual of High Risk Pregnancy and Delivery E-Book” by Elizabeth S. Gilbert
from Manual of High Risk Pregnancy and Delivery E-Book
by Elizabeth S. Gilbert
Elsevier Health Sciences, 2010

Lovset J. Preventive treatment of severe bleeding in placenta previa.

“Practical Guide to High Risk Pregnancy and Delivery E-Book” by Fernando Arias, Amarnath G Bhide, Arulkumaran S, Kaizad Damania, Shirish N Daftary
from Practical Guide to High Risk Pregnancy and Delivery E-Book
by Fernando Arias, Amarnath G Bhide, et. al.
Elsevier Health Sciences, 2012

If a previa is present, immediate cesarean section is indicated.

“Obstetrics and Gynecology at a Glance” by Errol R. Norwitz, John O. Schorge
from Obstetrics and Gynecology at a Glance
by Errol R. Norwitz, John O. Schorge
Wiley, 2013

Oktay Kutluk

Kutluk Oktay, MD, FACOG is one of the world's foremost experts in fertility preservation as well as ovarian stimulation and in vitro fertilization for infertility treatments. He developed and performed the world's first ovarian transplantation procedures as well as pioneered new ovarian stimulation protocols for embryo and oocyte freezing for breast and endometrial cancer patients.

Mail: [email protected]
Telephone: +1 (877) 492-3666

Biography: https://medicine.yale.edu/profile/kutluk_oktay/
Bibliography: oktay_bibliography

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