Vasa praevia (Complete) Flashcards
(7 cards)
Define vasa praevia
Condition where unprotected foetal vessels run dangerously close to or across the internal os.
These vessels are prone to rupture during rupture of membranes leading to foetal haemorrhage
What are the main risk factors for vasa praevia
Assisted reproduction technologies (ART) [e.g. IVF]
Multiple pregnancies
Previous uterine surgery (e.g. C-section)
Placental abnormalities
- Placenta praevia
- Velementous cord insertion
- Biloped placenta
Malpresentation (e.g. breech)
Increased maternal age
Previous history of vasa praevia
What are the main clinical features of vasa praevia?
Classic triad:
- Painless vaginal bleeding
- Rupture of membranes
- Foetal bradycardia
What investigations should be performed in patients with suspected vasa praevia?
Bedside:
Basic obs: Check haemodynamic status
CTG: Check for foetal bradycardia
Bloods:
FBC: Check anaemia
Group and save and cross match: If transfusion requires
Clotting screen
Rhesus status
Kleihauer test
Imaging:
Transvaginal USS: Gold-standard
What investigation is diagnostic for vasa praevia?
Transvaginal USS
How are patients with vasa praevia managed?
Elective C-section at 35-36 weeks
Emergency C-section if rupture of membranes
What are the main complications of vasa praevia?
Foetal complications:
Haemorrhage
Hypoxia
Perinatal death
Maternal complications:
Preterm delivery
Post-partum haemorrhage
