vasa praevia

Question 1

what

Answer 1

fetal vessels are within chorioamniotic membranes and travel across internal cervical os

Question 2

fetal vessels

Answer 2

2 umbilical arteries

umbilical vein

Question 3

normal circumstances

Answer 3

umbilical cord contains fetal vessels and inserts directly into placenta

fetal vessels are always protected, either by umbilical cord or placenta

Question 4

vasa praevia pathophysiology

Answer 4

fetal vessels exposed w/o protection of umbilical cord or placenta

they travel through chorioamniotic membranes and cross the internal cervical os

Question 5

T1 vasa praevia

Answer 5

vessels exposed as a velamentous umbilical rod
- umbilical cord inserts into the chorioamniotic membranes, and the fetal vessels travel unprotected through the membranes before joining the placenta

Question 6

T2 vasa praevia

Answer 6

fetal vessels are exposed as they travel to an accessory placental lobe

Question 7

risk factors

Answer 7

low lying placenta
IVF pregnancy
multiple pregnancy

Question 8

presentation

Answer 8

picked up on USS
APH
vaginal exam during labour - pulsating fetal vessels seen
during labour with fetal distress and dark-red bleeding

Question 9

Mx - asymptomatic

Answer 9

steroids given from 32wks

elective CS 34-36wks

Question 10

Mx - APH

Answer 10

emergency CS