Risk Factors for Vasa Praevia, and How the Baby can be Saved

What is Vasa Praevia?

Vasa praevia is a rare condition where the fetal blood vessels (or their branches) in the umbilical cord cross the fetal membranes (bag of waters) across the lower part of the uterus, between the baby and the cervical opening. So the vessels end up being between the baby’s leading part (usually the head) and the cervical opening.

There is usually no problem until labour starts. Once the cervix starts dilating, the delicate vessels are stretched and soon tear, resulting in intense vaginal bleeding. This is actually the baby’s blood, seriously endangering the baby’s life.

Vasa praevia has a very high infant mortality rate due to either of these factors:
  • the baby is rapidly drained of blood, resulting from vessels tearing when the amniotic membranes rupture; or
  • the baby’s blood supply is shut down, resulting from the vessels being pinched off as they are compressed between the baby and the walls of the birth canal.
Since in this condition, this very delicate vessel arrangement is positioned between the baby and the cervix, it is frequently the thinning and opening of the cervix and pressure from the baby on these vessels that brings about the baby’s death.


Pre-disposing Risk Factors:

Some conditions increase the risk of vasa praevia, including: 
  • A low lying placenta (placenta praevia)
  • Multiple pregnancy (twins or more)
  • A placenta with an extra lobe (succenturiate lobe)
  • A placenta where the cord insertion is peripheral rather than central (velamentous insertion of cord)
  • IVF pregnancy: the risk of vasa praevia is increased to an estimated 1 in 300
  • Previous history of uterine surgery, including minor procedures (D & C, etc)



So What Can Be Done to SAVE these Babies?

When vasa praevia is detected before labour, the baby has a much greater chance of surviving: the baby is then delivered by caesarean section, usually saving the baby’s life. Yet, despite medical advances, vasa praevia is often undetected until fatal vessel rupture occurs.

Transvaginal ultrasound (an ultrasound view of the cervix) in combination with colour doppler (which can show blood flowing through veins) is the most effective method for diagnosing vasa praevia during pregnancy.

Vasa praevia is not routinely looked for and seldom found before delivery. Transvaginal, colour doppler ultrasounds should be done as a matter of course following the suspicion any implantation abnormalities. This is not standard practice at this time.

Please ask your doctor for this test. Tell them about vasa praevia and insist that you get a test.


Remember…It only takes a moment to diagnose the condition and save your baby’s life.

Comments (6)

Said this on 07-02-10 At 12:44 am
Very well said! I also lost a baby to undiagnosed vasa previa.
Said this on 24-09-10 At 02:38 pm

I also lost my son in June this year with a diagnosed Vasa Previa. Unfortunately my waters broke at home at 35 weeks. My doctor didn't feel it necessary to admit me prior to 36 weeks despite my constant pleas for admission after my diagnosis at 32 weeks. Everyday I still ask how this is happening when the survival rate is so high when the proper scans and management is followed. I hope the doctors start taking more responsibility for the lives of the babies lost -- with modern day medicine there is no excuse.  

J
Said this on 04-11-12 At 06:56 am

On Tuesday we will bury my beautiful granddaughter.  We are devastated!  Why wasn't this diagnosed?

Eman
Said this on 09-08-11 At 05:53 pm

I lost my daughter who was diagnosed with Vasa Previa due to bleeding. I was offered to go home. I begged to stay. Unfortunately, despite spending 7 weeks in the hospital to avoid this tragedy,  the OB oncall that night kept underestimating the bleeding and maybe didn't read the case properly. It took her 40 minutes to decide, and then she complicated matters by giving a spinal anaesthesia instead of general anaestesia. OB's: please take Vasa Praevia seriously. I also think that the medical guidelines should be revised, regarding the urgency of the situation when a rupture happens and regarding clarity on the type of anaethesia required. I am sorry to say that despite medical advances, we still lose perfectly healthy babies because of malpractice and irresponsibilty of some physicians.

angela
Said this on 21-10-11 At 11:46 am

This website was very helpful to me. My son is now 2 years old and we had Vasa Praveia. It was not detected during regular checkups. At my 36th week check-up, the doctor ruptured the vessels with a manual exam. He thought he broke my water. I rushed to the ER and the horror began. I laid for 2 days without knowing anything. Doctors were scared to check me because as soon as the exam was performed I would gush blood. Day 3: they decided to start with “Patosin” and after some hours they took me off. It did not work. Day 4: a wonderful doctor decided to perform a c-section. And my son was born, healthy as can be. It was only after research and further examination of previous ultrasounds did they finally rule that it was Vasa Previa. I agree: this is serious and more coloured ultrasounds should be used.

kathryn
Said this on 22-03-13 At 12:36 pm

I started bleeding profusely while at a pre-natal class.  My husband rushed me to the hospital, and I continued to bleed all night.  My baby (who is now 11) has CP, chronic kidney failure and the left side of his brain is completely damaged.  I began bleeding at 8 p.m and my OB did not deliver him (by emergency c-section) until 8:am the next day.  This is something I'd never heard about.  I wonder if I can re-open my case against the doctor and the hospital for not delivering him when I first was admitted.  This will be a lifelong problem for him.  I was at 39 1/2 weeks.

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