Clinical case of delivery of a pregnant woman with vasa previa

Abstract

Anomalies of the umbilical cord are manifold and pose the greatest danger during the development of labor. Sheath attachment of the umbilical cord is one of the common causes of presentation of umbilical cord vessels. Vasa previa (VP) causes diagnostic difficulties, cannot be corrected during pregnancy and does not affect the birth process, but is characterized by a high frequency of perinatal mortality. This observation demonstrates the need for close attention of obstetrician-gynecologists and ultrasound doctors to such a rare condition as VP. The article discusses the clinical case of successful delivery of a pregnant woman with this pathology.

Keywords

vasa previa / umbilical cord attachment / successful delivery

References

[1] Ismail K.I., Hannigan A., O’Donoghue K., Cotter A. Abnormal placental cord insertion and adverse pregnancy outcomes: a systematic review and meta-analysis. Systematic Reviews. 2017; 6(1): 242. doi: 10.1186/s13643-017-0641-1

[2] Baergen R.N. Pathology of the Umbilical Cord, in Manual of Pathology of the Human Placenta. 2nd ed. N.Y.: Springer Science & Business Media; 2011.

[3] Hasegawa J., Farina A., Nakamura M. et al. Analysis of the ultrasonographic findings predictive of vasa previa. Prenat. Diagn. 2010; 30 (12-13): 1121-5.

[4] Malanina E.N., Kozyreva E.V. Prenatal diagnosis of vascular presentation: an analysis of two clinical cases. Prenatal’naya diagnostika. 2017; 16 (3): 280-2. (in Russian)

[5] Ruiter L., Kok N., Limpens J., Derks J.B., De Graaf I.M., Mol B.W.J., Pajkrt E. Systematic review of accuracy of ultrasound in the diagnosis of vasa previa. Ultrasound Obstet. Gynecol. 2015; 45 (5): 516-22.

[6] Vintzileos A.M., Ananth C.V., Smulian J.C. Using ultrasound in the clinical management of placental implantation abnormalities. Am. S. Obstet. Gynecol. 2015; 213 (4): S.71-S77. doi: 10.1016/ j.ajog.2015.05.059

[7] Savel’yeva G.M., Sukhikh G.T., Serov V.N., Radzinskiy V.E., eds. Obstetrics: National Leadership. [Akusherstvo: Natsional’noye rukovodstvo]. Ed. 4th, rev. and add. Moscow: GEOTAR-Media; 2019. (in Russian)

[8] Gerasimova L.I., Denisova T.G., Mnoyan E.A. Etiopathogenesis, risk factors for development and complications of vasa previa. Zdravookhraneniye Chuvashii. 2011; (3): 69-76. (in Russian)

[9] Cravageot B. L’ insertion vélamenteuse du cordon [Ressource électronique]: quand le fil de la vie devient anomalie. Nancy: Université Henri-Poincaré; 2010.

[10] Gagnon R. et al. SOGC Clinical Practice Guideline: guidelines for the management of vasa previa. Int. J. Gynaecol. Obstet. 2010; 108 (1): 85-9.

[11] Devyatova E.A. Abnormalities in the location and attachment of the placenta are risk factors for preterm pregnancy, cesarean section and adverse perinatal outcomes. Akusherstvo i ginekologiya. 2016; (3): 17-24. (in Russian)

[12] Shchegolev A.I., Tumanova U.N. Pathology of the placenta with fetal growth retardation. Mezhdunarodnyy zhurnal prikladnykh i fundamental’nykh issledovaniy. 2017; (12, ch.2): 297-301. (in Russian)

[13] Vahanian S., Lavery S., Ananth C., Vitzileos A. Placental implantation and risk of preterm delivery a systematic review and metaanalysis. Am. J. Obstet. Gynecol. 2015; 213 (4): S78-90. doi :10.1016 / j. ajog.2015.05.059

[14] De Los Reyes S., Henderson J., Eke A.C. A systematic review and meta-analysis of velamentous cord insertion among singleton pregnancies and the risk of preterm delivery. Int. J. Gynaecol. Obstet. 2018;142(1): 9-14. doi: 10.1002/ijgo.12489

[15] Gerasimova L.I., Denisova T.G., Mnoyan E.A. Diagnosis and management of pregnancy with vasa previa. Zdravookhraneniye Chuvashii. 2011; (4): 78-85. (in Russian)

[16] Catanzarite J.C., Mondestin-Sorrentino M., Muench M.V. et al. Vasa Previa. Prenatal diagnosis and evaluation with 3-dimensional sonography and power angiography. J. Ultrasound Med. 2005; 24: 721-4.

[17] Hasegawa J., Matsuoka R., Ichizuka K. et al. Velamentous cord insertion into the lower third of the uterus is associated with intrapartum fetal heart rate abnormalities. Ultrasound Obstet. Gynecol. 2006; 27 (2): 425-9.

[18] Oyelese Y., Catanzarite V., Prefumo F. et al. Vasa previa: the impact of prenatal diagnosis on out comes. Obstet. Gynecol. 2004; 103: 937-42.

[19] Pretorius D.H., Chau C., Poeltler D.M. et al. Placental cord insertion visualization with prenatal ultrasonography. J. Ultrasound Med. 1996; 15: 585-93.

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