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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.
Normal umbilical cord insertion and velamentous umbilical cord insertion in pregnancy, with and without vasa previa. Specialty: Obstetrics Symptoms: Blood vessel compression, [1] [2] decrease in blood supply to the fetus, [2] [3] impaired growth and development of the fetus. [4] [5] Risk factors
A placental infarction results from the interruption of blood supply to a part of the placenta, causing its cells to die.. Small placental infarcts, especially at the edge of the placental disc, are considered to be normal at term.
Besides placenta previa and placental abruption, uterine rupture can occur, which is a very serious condition leading to internal or external bleeding. Bleeding from the fetus is rare, but may occur with two conditions called vasa previa and velamentous umbilical cord insertion where the fetal blood vessels lie near the placental insertion site unprotected by Wharton's jelly of the cord. [11]
Previa can be confirmed with an ultrasound. [21] Transvaginal ultrasound has superior accuracy as compared to transabdominal one, thus allowing measurement of the distance between the placenta and cervical os. This has rendered the traditional classification of placenta praevia obsolete. [22] [23] [24] [25]
The bleeding may be due to placental abruption, uterine rupture, placenta accrete, undiagnosed placenta previa, or vasa previa. [3] Cesarean section is indicated. Post-partum hemorrhage is defined by the loss of at least 1,000 mL of blood accompanied with symptoms of hypovolemia within 24 hours after delivery.
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.
Placenta praevia or vasa praevia refers to the placenta or fetal blood vessels, respectively, covering or being located close to the opening of the uterus. More than half of women affected by placenta praevia (51.6)% have bleeding before delivery. [12] Vasa praevia occurs in about 0.6 per 1000 pregnancies. [13]