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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 .
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]
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[2] [3] The diagnosis should be suspected if there is a sudden decrease in the baby's heart rate during labor. [4] [2] Seeing or feeling the cord confirms the diagnosis. [4] Management focuses on quick delivery, usually by cesarean section. [4] Filling the bladder or pushing up the baby by hand is recommended until this can take place. [4]
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.
An important risk factor for placenta accreta is placenta previa in the presence of a uterine scar. Placenta previa is an independent risk factor for placenta accreta. Additional reported risk factors for placenta accreta include maternal age and multiparity, other prior uterine surgery, prior uterine curettage, uterine irradiation, endometrial ablation, Asherman syndrome, uterine leiomyomata ...