Antenatal Care - Vasa Praevia Flashcards
What is Vasa Praevia?
A condition where the foetal vessels are within the foetal (chorioamniotic) membranes and travel across the internal cervical os.
What do the foetal membranes surround?
Amniotic cavity and developing foetus.
What do the foetal vessels consist of?
2 Umbilical Arteries and 1 Umbilical Vein.
Physiology of Umbilical Cord (3).
- It inserts directly into the placenta.
- Foetal Vessels are either protected by the Umbilical Cord or Placenta.
- Umbilical Cord contains Wharton’s Jelly (layer of soft connective tissue that surround blood vessels).
What are the 2 instances when the foetal vessels may be exposed?
- Velamentous Umbilical Cord (it inserts into the chorioamniotic membranes and foetal vessels travel unprotected through the membranes before joining the placenta).
- Accessory/Succenturiate Lobe of Placenta.
Types of Vasa Praevia (2).
- Type I - Foetal Vessels exposed as a Velamentous Umbilical Cord.
- Type II - Foetal Vessels are exposed as they travel to an Accessory Placental Lobe.
Risk Factors of Vasa Praevia (3).
- Low Lying Placenta.
- IVF Pregnancy.
- Multiple Pregnancy.
What is the danger of Vasa Praevia?
Prone to bleeding, especially during rupture of membranes, leading to foetal blood loss and death.
Clinical Presentation of Vasa Praevia (2).
- Antepartum Haemorrhage (during 2nd/3rd Trimester).
2. Labour : Foetal Distress and Dark-Red Bleeding Following Rupture.
Investigations of Vasa Praevia (3).
- Diagnosis : US.
- Incidental : Vaginal Examination during Labour (Pulsating Foetal Vessels seen through Dilated Cervix).
- CTG : Foetal Bradycardia.
Management of Vasa Praevia (3).
Asymptomatic :
- Corticosteroids from Week 32.
- Elective C-Section (34-36 Weeks).
Symptomatic :
3. APH - Emergency C-Section.
