Vasa previa is a rare pregnancy complication.  It is different than placenta previa, which is another pregnancy complication.  Vasa previa is when the blood vessels that connect the umbilical cord to the placenta are near the birth canal.  The umbilical cord sometimes doesn’t connect to the placenta, which can leave unprotected blood vessels.  When these unprotected blood vessels travel across the opening of the cervix it can cause complications. 

During labor the amniotic sac ruptures, if these unprotected blood vessels lie over the cervix when the amniotic sac ruptures it can cause the blood vessels to rupture as well.  This can lead to blood loss and even death for the fetus. 

When vasa previa is diagnosed and caught early enough the success rate is 97%.  Left untreated, or undiagnosed 57% of those cases end in stillbirths.  Vasa previa affects 1 in every 2500 deliveries. 

 

Types Of Vasa Previa

There are two different types of vasa previa. 

Vasa previa with velamentous cord insertion is when the umbilical cord doesn’t attach to the placenta.  The umbilical cord attaches into the amniotic sac instead, causing the blood vessels to be unprotected and for them to travel outside of the placenta.  This causes even more concern if your placenta is low near or covering your cervix.  A low placenta can increase the risk of the blood vessels bursting when labor starts and the fetus moves to the cervix. 

The second is bilobed placenta.  The placenta can form two different lobes.  If there are more than two it is called multi lobed placenta.  In the bilobed placenta the umbilical cord connects one lobe to the other.  Between the two lobes are unprotected blood vessels that are unprotected.  These unprotected blood vessels can lie against the cervix, which also poses a risk of bursting if labor starts.  

 

Symptoms

There are usually no symptoms that go along with vasa previa.  You may not know you have the condition until an ultrasound is done. 

Sometimes women experience painless dark colored vaginal bleeding. 

 

Diagnosis

Vasa previa is diagnosed through ultrasound.  Usually during a routine ultrasound done between 18 and 26 weeks.  If there is a concern for vasa previa the ultrasound tech may do a transvaginal ultrasound to see the blood vessels and where they are.  Your doctor may also use the colored setting to check blood flow to the baby.  When looking at the ultrasound your doctor will be looking at the location of the placenta, how many lobes the placenta has, and the location of the umbilical cord. 

 

Risk Factors

You are at a higher risk for vasa previa if you have placenta previa.  Placenta previa is when your placenta is low and partially or fully covers the cervix. 

If you have gotten pregnant through invitro fertilization it raises your risk of vasa previa.

Smoking or having a chronic condition such as diabetes also raises your risk.

Pregnancy with multiples or a pregnancy later in life also raises your risk.

Women who have had a previous c-section, or have had previous uterine surgery are also at a higher risk.

 

Treatment

If you are found to have vasa previa you will be deemed a high risk pregnancy.  You will be closely monitored throughout the rest of your pregnancy.  The doctor will keep a close eye on you to make sure that your body doesn’t go into labor too early. 

Once diagnosed with vasa previa your doctor will schedule your c-section to be done between 34-37 weeks.  You may be given corticosteroids to help the baby’s lungs develop since they will be born early.  Nonstress tests will be done on the baby twice a week starting about 28 weeks.  Pelvic rest may be recommended. 

In some cases you may be hospitalized at 30-32 weeks to be even more closely monitored.  If labor starts and you have a lot of vaginal bleeding, you will need medical assistance immediately. 

There usually is no harm done to the baby with vasa previa, as long as a c-section is performed.  Some babies will need to have a short stay in the NICU because of the early delivery. 

Babies who are born vaginally with vasa previa usually die.  The rupture of the blood vessels can cause too much blood loss, or the blood vessels can become pinched, which can restrict blood flow and cause your baby to have brain damage.  

 

Takeaway

There is a 97% success rate in cases that are diagnosed and delivered through c-section.  Vasa previa is a very rare pregnancy complication.  Only affecting 1 in every 2500 deliveries.  Early detection can lead to a healthy birth for mother and baby.

 

 

 

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