Association of Vasa Previa at Delivery With a History of Second-Trimester Placenta Previa

2004 ◽  
Vol 59 (4) ◽  
pp. 245-247 ◽  
Author(s):  
Karrie Francois ◽  
Staci Mayer ◽  
Cathleen Harris ◽  
Jordan H. Perlow
Keyword(s):  
Placenta Previa ◽  
Second Trimester ◽  
Vasa Previa ◽  
History Of

Vasa previa: when antenatal diagnosis can change fetal prognosis

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Miriam Sutera ◽  
Anna Garofalo ◽  
Eleonora Pilloni ◽  
Silvia Parisi ◽  
Maria Grazia Alemanno ◽  
...  
Keyword(s):  
Risk Factor ◽  
Predictive Value ◽  
Placenta Previa ◽  
Color Doppler ◽  
Transvaginal Ultrasound ◽  
Spontaneous Resolution ◽  
Fetal Mortality ◽  
Second Trimester ◽  
Vasa Previa ◽  
Fetal Vessels

Abstract Objectives Evaluate ultrasound diagnostic accuracy, maternal−fetal characteristics and outcomes in case of vasa previa diagnosed antenatally, postnatally or with spontaneous resolution before delivery. Methods Monocentric retrospective study enrolling women with antenatal or postnatal diagnosis of vasa previa at Sant’Anna Hospital in Turin from 2007 to 2018. Vasa previa were defined as fetal vessels that lay 2 cm within the uterine internal os using 2D and Color Doppler transvaginal ultrasound. Diagnosis was confirmed at delivery and on histopathological exam. Vasa previa with spontaneous resolutions were defined as fetal vessels that migrate >2 cm from uterine internal os during scheduled ultrasound follow-ups in pregnancy. Results We enrolled 29 patients (incidence of 0.03%). Ultrasound antenatally diagnosed 25 vasa previa (five had a spontaneous resolution) while four were diagnosed postnatally, with an overall sensitivity of 96.2%, specificity of 100%, positive predictive value of 96.2%, and negative predictive value of 100%. Early gestational age at diagnosis is significally associate with spontaneously resolution (p 0.023; aOR 1.63; 95% IC 1.18–2.89). Nearly 93% of our patient had a risk factor for vasa previa: placenta previa at second trimester or low-lying placenta, bilobated placenta, succenturiate cotyledon, velametous cord insertion or assisted reproduction technologies. Conclusions Maternal and fetal outcomes in case of vasa previa antenatally diagnosed are significally improved. Our data support the evaluation of umbilical cord insertion during routine second trimester ultrasound and a targeted screening for vasa previa in women with risk factor: it allows identification of fetus at high risk, reducing fetal mortality in otherwise healthy newborns.

scholarly journals Risk factors of the previa placenta formation

2016 ◽  
Vol 65 (3) ◽  
pp. 25-31
Author(s):  
Natalya I Fadeeva ◽  
Olga A Belnitskaya ◽  
Irina A Myadelets ◽  
Galina V Serdyuk ◽  
Maria G Nikolaeva
Keyword(s):  
Risk Factors ◽  
Comparative Analysis ◽  
High Risk ◽  
Placenta Previa ◽  
Intrauterine Device ◽  
Adverse Outcomes ◽  
Second Trimester ◽  
Gynecological Disorders ◽  
History Of ◽  
Autoimmune Processes

Placenta previa is associated with a high risk of adverse outcomes for the fetus and mother. The aim of our study was to identify risk factors form a complete placenta previa. A comparative analysis of clinical and paraclinical characteristics of 70 patients with placenta previa in time delivery, 150 women with favorable migration in the second trimester placenta previa at baseline and 100 women with physiological placentation. It was found that a history of hormone-dependent gynecological disorders (p < 0.001), infertility (p < 0.001), contraceptive intrauterine device (p < 0.05), as well as hypertensive syndrome (p < 0.001), presence of hemostasis and folate metabolism defective alleles genes associations (p < 0.01) hepatitis B and C (p < 0.001), and autoimmune processes (p < 0.001) are risk factors of conservation of total placenta previa to delivery.

scholarly journals Evolution of second trimester low implanted placenta to previa at term: a prospective cohort study

2018 ◽  
Vol 7 (11) ◽  
pp. 4330
Author(s):  
Omar M. Shaaban ◽  
Hamdy A. Ahmed ◽  
Mohammed K. Ali ◽  
Ahmed M. Abbas ◽  
Ahmed Nasr ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Cohort Study ◽  
Pregnant Women ◽  
Prospective Cohort ◽  
Placenta Previa ◽  
Lower Edge ◽  
Second Trimester ◽  
History Of

Background: The objective of this study is to identify the percentage of low implanted placenta (LIP) at second trimester of pregnancy and identify the risk factors of its persistence to placenta previa (PP) at term.Methods: Through a registered prospective cohort study conducted at tertiary hospital in Upper Egypt, authors screened all pregnant ladies comes to present facility for antenatal second trimester USG between 18-24 weeks gestation. All participants interviewed for detailed risk factors of placenta previa. Those diagnosed to have a LIP (≤1.5 cm from the internal os) had had TVS to confirm the exact distance between the lower edge of the placenta and the internal os. Serial USG had been done every 4 weeks up to delivery to measure the same distance. The primary outcome was the percentage of LIP at 18-24 weeks. Logistic regression analysis was performed to predict the risk factors for PP at term.Results: Through screening of 1000 pregnant lady, LIP had been identified in (52 cases) 5.2% of pregnant women between 18-24 weeks. This percentage dropped gradually to reach 1.3% at 36 weeks of gestation and at time of delivery. The logistic regression analysis demonstrated that the distance between the internal os and the lower edge of the placenta between 18-24 weeks was the single significant variable associated with PP at term (p<0.001, odds ratio 0.319, 95% CI 0.20-0.50). However, excluding the distance from the regression model demonstrated other risk factors as previous miscarriage, previous cesarean section (CS), and history of multiple pregnancies and history of previous PP.Conclusions: About 5.0% of pregnant women have LIP at the second trimester of pregnancy (18-24 weeks) and only 25.0 % of them remain placenta previa at term. A cut-off value of 10 mm between the internal os and the lower edge of the placenta is the most important predictor of development of PP.

scholarly journals Vasa previa: a case report

2020 ◽  
Vol 9 (10) ◽  
pp. 4301
Author(s):  
Ipsita Mohapatra ◽  
Subha R. Samantaray ◽  
V. Naga Sindhuja
Keyword(s):  
Neonatal Outcome ◽  
Placenta Previa ◽  
Placental Tissue ◽  
Multiple Pregnancies ◽  
Lower Segment ◽  
Vitro Fertilization ◽  
Vasa Previa ◽  
History Of ◽  
Fetal Vessels

Vasa previa is defined as a condition where fetal vessels traverse the membranes in the lower segment below the presenting part unsupported by placental tissue or umbilical cord. Rupture of the membranes leads to fetal exsanguinations and even neonatal death. The etiology is uncertain, but risk factors include bilobed or succenturiate lobed placenta, velamentous insertion of cord, placenta previa, pregnancies resulting from In vitro fertilization (IVF) and multiple pregnancies. We report here a case of 24 year old woman, G3A2 at 34 weeks of gestation and history of 2 previous spontaneous abortions with vasa previa which was successfully managed. Prenatal sonographic diagnosis has the potential to improve or prevent the poor obstetric and neonatal outcome associated with it.

The Natural History of Trisomy 21: Outcome Data from a Large Tertiary Referral Centre

2021 ◽  
pp. 1-7
Author(s):  
Clare O’Connor ◽  
Rebecca Moore ◽  
Peter McParland ◽  
Heather Hughes ◽  
Barbara Cathcart ◽  
...  
Keyword(s):  
Trisomy 21 ◽  
Pregnancy Loss ◽  
Loss Rate ◽  
Outcome Data ◽  
Second Trimester ◽  
Referral Centre ◽  
Tertiary Referral ◽  
Tertiary Referral Centre ◽  
History Of ◽  
Baseline Demographic

<b><i>Objective:</i></b> The aim of the study was to prospectively gather data on pregnancy outcomes of prenatally diagnosed trisomy 21 (T21) in a large tertiary referral centre. <b><i>Methods:</i></b> Data were gathered prospectively in a large tertiary referral centre over 5 years from 2013 to 2017 inclusively. Baseline demographic and pregnancy outcome data were recorded on an anonymized computerized database. <b><i>Results:</i></b> There were 1,836 congenital anomalies diagnosed in the study period including 8.9% (<i>n</i> = 165) cases of T21. 79% (<i>n</i> = 131) were age 35 or older at diagnosis. 79/113 (69.9%) women chose a termination of pregnancy (TOP) following a diagnosis of T21. Amongst pregnancies that continued, there were 4 second-trimester miscarriages (4/34, 11.7%), 9 stillbirths (9/34, 26.4%), and 1 neonatal death, giving an overall pregnancy and neonatal loss rate of 14/34 (41.1%). <b><i>Conclusion:</i></b> The risk of foetal loss in prenatally diagnosed T21 is high at 38% with an overall pregnancy loss rate of 41.1%. This information may be of benefit when counselling couples who are faced with a diagnosis of T21 particularly in the context of limited access to TOP.

scholarly journals A close call: does the location of incision at cesarean delivery matter in patients with vasa previa? A case report.

F1000Research ◽  
2013 ◽  
Vol 2 ◽  
pp. 267 ◽  
Author(s):  
Werner M Neuhausser ◽  
Laxmi V Baxi
Keyword(s):  
Case Report ◽  
Cesarean Section ◽  
Post Partum ◽  
Elective Cesarean Section ◽  
Second Trimester ◽  
Uterine Incision ◽  
Vasa Previa ◽  
Close Call ◽  
Elective Cesarean ◽  
Utmost Care

We present here a case of vasa previa in a multipara, diagnosed at the time of her late second trimester ultrasonogram. The patient subsequently underwent an elective cesarean section after 37 weeks gestation, giving birth to a healthy child with an uneventful post-partum, neonatal and infant course. At the time of cesarean section, the incision was gradually deepened in layers through the myometrium by utmost care allowing the amniotic sac to protrude through the uterine incision hereby avoiding laceration of the vasa previa and its branches. Fetal exsanguination and a need for blood transfusion as well as a possible adverse neonatal course were therefore avoided.

scholarly journals Nationwide population-based cohort study of adverse obstetric outcomes in pregnancies with myoma or following myomectomy: Retrospective cohort study

2020 ◽  
Author(s):  
Se Jin Lee ◽  
Hyun Sun Ko ◽  
Sunghun Na ◽  
Jin Young Bae ◽  
Won Joon Seong ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cesarean Section ◽  
Uterine Rupture ◽  
Placenta Previa ◽  
Multivariate Logistic Regression Analysis ◽  
Population Based ◽  
Obstetric Outcomes ◽  
Nulliparous Women ◽  
History Of ◽  
Adverse Pregnancy

Abstract Background: Our objective was to evaluate risks of adverse obstetric outcomes in pregnancies with myoma(s) or in pregnancies following myomectomy. Methods: We analyzed the national health insurance database, which covers almost the entire Korean population, between 2004 and 2015. The risks of adverse pregnancy outcomes in pregnancies with myoma(s) or in pregnancies following myomectomy, compared to those in women without a diagnosed myoma, were analyzed in multivariate logistic regression analysis. Results: During the study period, 38,402 women with diagnosed myoma(s), 9,890 women with a history of myomectomy, and 740,675 women without a diagnosed myoma gave birth. Women with a history of diagnosed myoma(s) and women with a history of myomectomy had significantly higher risks of cesarean section (aOR 1.13, 95% CI 1.1-1.16 and aOR 7.46, 95% CI 6.97-7.98, respectively) and placenta previa (aOR 1.41, 95% CI 1.29-1.54 and aOR 1.58, 95% CI 1.35-1.83, respectively), compared to women without a diagnosed myoma. And the risk of uterine rupture was significantly higher in women with previous myomectomy (aOR 12.78, 95% CI 6.5-25.13), compared to women without a diagnosed myoma, which was much increased (aOR 41.35, 95% CI 16.18-105.69) in nulliparous women. The incidence of uterine rupture was the highest at delivery within one year after myomectomy and decreased over time after myomectomy. Conclusions: Women with a history of myomectomy had significantly higher risks of cesarean section and placenta previa compared to women without a diagnosed myoma.

scholarly journals PLACENTA PREVIA

2009 ◽  
Vol 16 (01) ◽  
pp. 139-144
Author(s):  
ZOONA SAEED ◽  
M. Saeed ◽  
M. IKRAM ◽  
Roohi Saeed ◽  
SHAZIA TAZIAN
Keyword(s):  
Placenta Previa ◽  
Previous History ◽  
Average Hospital Stay ◽  
Short Term ◽  
Average Hospital ◽  
Intraoperative Complication ◽  
Causative Factors ◽  
History Of ◽  
Rising Incidence ◽  
Post Graduate Institute

Objectives: To analyze the causative factors and short term complications in cases of placenta previa. D e s i g n a ndSettings: A retrospective study carried out in Obstetrics and Gynecology Department of Sheikh Zayed Post Graduate Institute Lahore.P e r i o d : From June 2004 to June 2007.Subject: Fifty patients with placenta previa. M a i n o u t c o m e m e a s u r e s : Age, parity, previouscesarean section, previous history of evacuation/myomectomy, average hospital stay, need for blood transfusions, emergency/electiveLSCS, associated maternal and fetal morbidity and mortality. Results: There were 50 cases of placenta previa over the period of 3 years.Most frequently occurring intra operative complication was postpartum hemorrhage in 19 patients (38%). Highest morbidity was due toanemia which was in 23 patients (46%). Maternal mortality was 2%, while neonatal mortality was 14%. C o n c l u s i o n : Placenta previa is amultifactorial disease. No doubt that the rising incidence of cesarean section is increasing the intraoperative complication associated withthe condition but other risk factors are also important like age, parity, history of evacuation etc.

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