Vasa previa is a rare but potentially fatal condition that can occur during pregnancy when blood vessels in the umbilical cord lie over or near the birth canal.
If you are pregnant or know someone who is, it’s important to be aware of the rare but deadly fetal complication called vasa previa. This can lead to catastrophic bleeding and often death for the baby. In this blog post, we will discuss vasa previa in detail, including symptoms and treatment options.
What is vasa previa?
Vasa previa is a rare but potentially fatal condition that can occur during pregnancy. It occurs when the baby’s umbilical cord blood vessels cross over or come into close contact with the mother’s cervix or placenta. This can cause the vessels to rupture, resulting in life-threatening bleeding for both the mother and baby.
It is a very rare condition, occurring in only about one out of every two to three thousand births.
It is most often diagnosed during pregnancy, typically during a routine ultrasound. However, it can also be diagnosed after delivery, when the baby is born with abnormal umbilical cord blood vessels.
If you are diagnosed with vasa previa, you will likely be advised to deliver your baby by cesarean section. This is because vasa previa can lead to life-threatening bleeding during vaginal delivery.
It is important to be closely monitored by your healthcare provider. This condition can be very dangerous for both you and your baby, so it is important to have a team of healthcare professionals who are familiar with vasa previa and can provide the best care possible.
What causes vasa previa?
There are a few different theories as to what causes vasa previa, but the most likely cause is an abnormal connection between the placenta and the baby’s umbilical cord. This connection can cause the baby’s blood vessels to cross over or lie next to the cervical opening, which can lead to rupture and bleeding. There are two main causes of vasa previa:
Velamentous cord insertion
In some cases, vasa previa may be caused by velamentous cord insertion. Your baby is fed by your placenta through the umbilical cord throughout pregnancy.
The umbilical cord usually connects to the center of the placenta, and the blood vessels are protected inside of this structure. Instead of the placenta, the umbilical cord is inserted into the amniotic sac in velamentous cord insertion.
When blood vessels run through the amniotic sac, they don’t have that protection. If the blood vessels in the amniotic sac are above the cervix, it causes vasa previa.
Bilobed, multilobed, or succenturiate placenta
The placenta might have two lobes, which is called a bilobed placenta. Sometimes it can form more than two lobes, which is called multilobed. A smaller lobe, called a succenturiate lobe, can also form. Vasa previa happens if the blood vessels that run between these lobes end up lying against the cervix.
The amniotic sac bursts when your baby is ready to come out. The baby then travels down the cervix and out through the vagina. If you have vasa previa, the rupture of the amniotic sac will also break blood vessels. This will result in blood loss in you and your baby.
What are the risk factors for vasa previa?
There are a few different factors that can increase your risk of vasa previa, including:
- Multiple gestations: Women who are pregnant with twins or triplets are more likely to have vasa previa.
- Previous cesarean delivery: If you’ve had a cesarean delivery in the past, you’re more likely to have vasa previa. This is because the uterine scar from a previous cesarean delivery can separate during pregnancy, which can cause the blood vessels to cross over or lie next to the cervical opening.
- Placenta previa: Placenta previa is when the placenta lies low in the uterus, and it can cause vasa previa.
- Cord accidents: Cord accidents, like vasa previa, can also cause velamentous cord insertion. This happens when the umbilical cord is damaged during pregnancy, delivery, or after the baby is born.
- In-vitro fertilization pregnancies
- Chronic health conditions such as diabetes
What are the symptoms of vasa previa?
Vasa Previa may go unnoticed until labor begins, and there are generally no symptoms. The most common symptom of vasa previa is painless vaginal bleeding during pregnancy, which is dark in color, usually after the 20th week.
The bleeding can be light or heavy, and it can range from pink to bright red. If you have vasa previa, you might also have:
- Abdominal pain
- Cramps
- Backache
- Your baby may also have a slow heartbeat
If you have any of these symptoms, it’s important to call your doctor right away.
How is vasa previa diagnosed?
Vasa previa is usually diagnosed with an ultrasound. An ultrasound can show if the baby’s blood vessels are crossing over or lying next to the cervical opening. Your doctor may also order a Doppler ultrasound, which can show where your blood vessels are.
How is vasa previa treated?
If you have vasa previa, your doctor will likely recommend that you have a cesarean delivery. This is because vasa previa can cause serious bleeding during labor and delivery. Treatments may include
- Nonstress testing should be done twice a week, beginning at 28 weeks and continuing up to 32 weeks, to monitor the baby’s health.
- Between 30 and 32 weeks, you may be admitted to the hospital to more closely observe the baby.
- Sometimes a baby’s lungs are not as mature as they should be. To help the baby, the doctor may give the baby a steroid shot. This will help the baby’s lungs to develop more quickly.
- You may be given a blood transfusion if you have heavy bleeding.
- Pelvic rest may be advised, which means avoiding sex or putting anything in your vagina.
- Between 34 and 37 weeks, a planned C-section is recommended. If your membranes break early, you have vaginal bleeding, or your baby is in distress, you will have an emergency C-section.
Complications of vasa previa
Complications of vasa previa include:
- Heavy bleeding during labor and delivery
- Premature birth
- Low birth weight
- Stillbirth
- Maternal death
Vasa previa is a rare but serious condition that can be deadly for both you and your baby.
Prevention of vasa previa
There is no known prevention for vasa previa. However, if you have risk factors for vasa previa, your doctor may recommend more frequent ultrasounds or C-section delivery.
If you have vasa previa, it’s important to get regular prenatal care, including ultrasounds. This can help your doctor to monitor your condition and your baby’s health. You will likely need to have a C-section delivery. This is the best way to prevent complications from vasa previa.
