Vasa Praevia

Question 1

Most accurate way to diagnose

Answer 1

TV USS using Doppler to evaluate the internal os and lower uterine segment

Question 2

Dx

Answer 2

Fetal vessel either covering or located within 2cm from the internal os.

Question 3

When to admit and deliver

Answer 3

Consider admission at 30 weeks
Consider delivery by 35 weeks
-no benefit to be gained by expectant management beyond 37 weeks

Question 4

Signs of potential vasa praevia

Answer 4

Fresh vaginal bleeding (+/- membrane rupture)
Acute fetal compromise
   -progressive tachycardia
   -prolonged bradycardia
   -sinusoids trace

Question 5

Type 1 vasa praevia

Answer 5

Velementous insertion of the umbilical cord into the placenta

Question 6

Type II vasa praevia

Answer 6

Velementous fetal vessel connecting the placenta to a six initiate placental lobe

Question 7

Diagnostic criteria for vasa praevia

Answer 7

Visualizing aberrant linear or tubular echolucent structures with 2D imaging
Demonstrating blood flow in these structures using colour or power Doppler
DeDemonstrating umbilical arterial/venous Doppler waveforms using pulse wave Doppler
Aberrant easels located over or within 2cm of the internal os attached to the inner perimeter of the fetal membranes

Question 8

Risk Factors for vasa praevia

Answer 8

Velementous cord insertion
Bi-lobed and succenturiate placental abnormalities
Praevia
LLP hx in 2nd trimester
IVF
Multiple pregnancy