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Vasa praevia or vasa previa is a complication of obstetrics in which fetal blood vessels cross or run near the internal opening of the uterus. Since these vessels are not protected by the umbilical cord or placental tissue , the rupture of the fetal membranes during birth causes them also to rupture, leading rapidly to death of the fetus.
[2] [25] This can result in increased risk of caesarean delivery, fetal hypoxia, and perinatal death in pregnancies with velamentous cord insertion. [2] Damage to the umbilical cord vessels can occur when the amniotic membranes are ruptured, particularly in the case of vasa previa, potentially leading to fetal exsanguination.
Vasa praevia is a very rare, presenting only 4:10,000 cases from the largest study of the condition. [16] Risks of antepartum bleeding due to vasa praevia greatly increase during the third trimester of pregnancy during cervical dilation or placenta praevia .
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Occasionally, a circumvallate placenta can also increase the risk of neonatal death and emergency caesarean section. Although there is no existing treatment for circumvallate placenta, physicians can attempt to minimize the effects of complications, if they occur, through frequent fetal monitoring and, if necessary, emergency cesarean section. [1]
In overt cord prolapse, the cord can be seen or felt on the vulva or vagina. [1] The main issue with cord prolapse is that, once the cord is prolapsed, it is prone to compression by the foetus and the womb. This can cause decrease in oxygen supply to the foetus which can be fatal.
It is used to differentiate whether the blood coming out of vagina is of the mother or fetus during delivery i.e, placenta previa versus vasa previa. It is based on the principle that fetal HbF is resistant to acids and alkali whereas the mother's blood which has HbA is sensitive to acid and alkaline.