Vasa previa

Background

• Fetal blood vessels from the umbilical cord run in close proximity to cervical os
  • Seldom recognized prior to vessel disruption

Risk Factors

• Placenta previa
• IVF
• Bilobed placenta

Evaluation

• Painless bleeding occurs during SROM
  • Fetal in origin (mother's life is not at risk)
  • May lead to fetal exsanguination

Differential Diagnosis

Abdominal Pain in Pregnancy

<20 Weeks

• Ectopic pregnancy
• First trimester abortion
  • Complete Abortion
  • Threatened Abortion
  • Inevitable Abortion
  • Incomplete Abortion
  • Missed Abortion
  • Septic abortion
• Ovarian torsion
• Incarcerated uterus
• Malposition of the uterus
• Non-pregnancy related causes

>20 Weeks

• Labor/Preterm labor
• Placental abruption
• Placenta previa
• Vasa previa
• Uterine rupture
• Vaginal trauma
• HELLP syndrome
• Chorioamnionitis
• Incarcerated uterus
• Malposition of the uterus
• Non-pregnancy related causes
• Placenta accreta
• Placenta increta
• Placenta percreta

Vaginal Bleeding in Pregnancy (>20wks)

• Placental abruption
• Placenta previa
• Vasa previa
• Uterine rupture
• Preterm labor
• Vaginal trauma
• Placenta accreta
• Intrauterine fetal demise

Management

C-section

See Also

• Pregnant vaginal bleeding

See Also

Vaginal Bleeding (Main)

Authors

Ross Donaldson, Allen Bookatz, Neil Young, Jordan Swartz, Daniel Ostermayer