HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Oyelese, Y. Articles by Smulian, J. C. Search for Related Content PubMed PubMed Citation Articles by Oyelese, Y. Articles by Smulian, J. C.

Vasa Previa: The Impact of Prenatal Diagnosis on Outcomes

Yinka Oyelese, MD^*, Val Catanzarite, MD, PhD, Federico Prefumo, MD, Susan Lashley, MD, Morey Schachter, MD^¶, Yosi Tovbin, MD^¶, Victoria Goldstein, MBA^|| and John C. Smulian, MD, MPH

From the Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, UMDNJ-Robert Wood Johnson Medical School/Robert Wood Johnson University Hospital, New Brunswick, New Jersey; *Department of Obstetrics and Gynecology, Georgetown University Hospital, Washington, DC; Maternal Fetal Medicine, Sharp Perinatal Center and Sharp Mary Birch Hospital, San Diego, California; Fetal Medicine Unit, Department of Obstetrics and Gynaecology, St. George’s Hospital Medical School, London, United Kingdom; ¶Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, Zerifin, Tel Aviv University, Israel; and ||Vasa Previa Foundation, Moline, Illinois.

Address reprint requests to: Yinka Oyelese, MD, Division of Maternal–Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, UMDNJ-Robert Wood Johnson Medical School, 125 Paterson Street, New Brunswick, NJ 08901; e-mail: YinkaMD{at}aol.com.

OBJECTIVE: To evaluate outcomes and predictors of neonatal survival in pregnancies complicated by vasa previa and to compare outcomes in prenatally diagnosed cases of vasa previa with those not diagnosed prenatally.

METHODS: We performed a multicenter study of 155 pregnancies complicated by vasa previa. Cases were obtained from the Vasa Previa Foundation and 6 large hospitals. Comparisons were made between groups based on prenatal diagnosis status and neonatal survival.

RESULTS: The overall perinatal mortality was 36% (55 of 155). In 61 cases (39%), vasa previa was diagnosed prenatally; 59 of 61 (97%) infants from these pregnancies survived compared with 41 of 94 (44%) in cases not diagnosed prenatally (P < .001). Median 1- and 5-minute Apgar scores in cases diagnosed prenatally were 8 and 9, respectively, compared with 1 and 4 among survivors in cases not diagnosed prenatally (P < .001). More than half (24 of 41) of surviving neonates born to women without prenatal diagnosis required blood transfusions compared with 2 of 59 diagnosed prenatally (P < .001). Multivariable logistic regression analysis showed that the only significant predictors of neonatal survival were prenatal diagnosis (P < .001) and gestational age at delivery (P = .01).

CONCLUSIONS: Good outcomes with vasa previa depend primarily on prenatal diagnosis and cesarean delivery at 35 weeks of gestation or earlier should rupture of membranes, labor, or significant bleeding occur.

LEVEL OF EVIDENCE: II-3

This article has been cited by other articles:

				W. Sepulveda Velamentous insertion of the umbilical cord: a first-trimester sonographic screening study. J. Ultrasound Med., August 1, 2006; 25(8): 963 - 968. [Abstract] [Full Text] [PDF]

				Y. Oyelese and J. C. Smulian Placenta previa, placenta accreta, and vasa previa. Obstet. Gynecol., April 1, 2006; 107(4): 927 - 941. [Abstract] [Full Text] [PDF]

				J. C. Canterino, M. Mondestin-Sorrentino, M. V. Muench, S. Feld, J. D. Baum, and C. O. Fernandez Vasa Previa: Prenatal Diagnosis and Evaluation With 3-Dimensional Sonography and Power Angiography J. Ultrasound Med., May 1, 2005; 24(5): 721 - 724. [Full Text] [PDF]