vasa praevia

Question 1

What is Vasa praevia (RF)

Answer 1

Foetal vessels run across the internal cervical oss, below the foetal presentin part
Unprotected by placental tissue/umbilical cord - > when baby descend rupture vessels
Type 1 - Unprotected vessels come from a single placenta to cord
Type 2- vessels are joining 2 lobes of placenta, one still attached to the ord

RF -
Foetal anomalie - bilobed placenta, succentuirate lobes
Hx of low lying placetna in 2nd trimester
Multiple preg, IVF

Question 2

Sx and Ix of Vasa praevia

Answer 2

Sx –
typical - ROM -> fresh PV bleeding and foetal bradycardia
(after rupture of membrane, veins alone cant hold baby- causes the bleed)
Foetal HR abnormalities- deceleration, brady
O/E- palpate vessels in membrane, amnioscope can see

Ix - Kleihauer test (measure for foetal Hb in matenral blood
Heamoglobin electrophoreesis can do same but takes long
Doppler USS

Question 3

Mx and complications of Vasa praevia

Answer 3

Mx - cesarian section

comp
no maternal risk but dangerous for foetus
Foetus - loss of small amounts of blood can be v bad for foetus- rapid delivery and aggressive ressus + transfusion needed

prog- foetal mortality if presenting with heamorrhage is 60%! but 3% if identified before