scholarly journals Clinical case of delivery of a pregnant woman with Vasa previa on the background of Placenta previa/accreta

2021 ◽  
Vol 4 ◽  
pp. 23-29
Author(s):  
О.V. Golyanovskiy ◽  
O.A. Dyadyk ◽  
V.I. Oshovskyy ◽  
N.E. Geint ◽  
V.V. Mekhedko ◽  
...  
Keyword(s):  
Pregnant Woman ◽  
Umbilical Cord ◽  
Clinical Case ◽  
Placenta Previa ◽  
Multiple Pregnancy ◽  
Diagnostic Methods ◽  
Doppler Imaging ◽  
Fetal Mortality ◽  
Standard Clinical Practice ◽  
Vasa Previa

Vasa previa is characterized by the presentation of blood vessels of the umbilical cord, which pass through the amniotic sac over the inner eye of the cervix or in its immediate vicinity (up to 5 cm) and are associated with umbilical cord blood flow and are in front of the anterior part of the fetus.Risk factors for Vasa Previa are placental pathology, in particular placenta previa and low placental location; membranous attachment of the umbilical cord, IVF, the presence of an additional share of the placenta or dichotomous placenta, as well as multiple pregnancy. Without prior diagnosis of Vasa previa, fetal mortality reaches 44%, while in antenatal detection the survival rate is up to 97%.Current standard clinical practice during pregnancy with obstetric risk factors for Vasa previa includes assessment of the condition of the lower segment of the uterus and cervix using TVUS and enhanced / color Doppler imaging. The use of additional modern diagnostic methods is a very important step in the aspect of differential diagnosis, especially when additional structures are visualized in the immediate vicinity of the cervix.The article describes a clinical case of Vasa previa on the background of Placenta previa / accreta in women with a burdened somatic and obstetric history and with 4 previous surgeries on the pelvic organs (laparotomy). The management of a clinical case with timely diagnosis and delivery with the help of modern medical and technical support of cesarean section (tranexamic acid, carbetocin, argon plasma tissue coagulation) is presented. Pathology and histology data confirming the diagnosis are attached as well.Thanks to the use of modern methods of diagnosis and delivery, it was possible to prevent severe complications, primarily hemorrhagic, both from the fetus and from the pregnant woman with a rather rare obstetric pathology in the form of Vasa previa with umbilical cord membranous attachment, Placenta previa / accreta partialis.

scholarly journals Clinical case of delivery of a pregnant woman with vasa previa

2020 ◽  
Vol 7 (1) ◽  
pp. 53-56
Author(s):  
E. P. Shevtsova ◽  
N. A. Linchenko
Keyword(s):  
Pregnant Woman ◽  
Umbilical Cord ◽  
High Frequency ◽  
Clinical Case ◽  
Rare Condition ◽  
Birth Process ◽  
Common Causes ◽  
Vasa Previa ◽  
Diagnostic Difficulties ◽  
The Common

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.

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 Vaginal birth after Cesarean section (VBAC)

2016 ◽  
Vol 10 (2) ◽  
Author(s):  
Javed Iqbal ◽  
Fouzia Nausheen ◽  
Fozia Ali Bhatti ◽  
Shahida Sheikh
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Placenta Previa ◽  
Multiple Pregnancy ◽  
Fetal Monitoring ◽  
Fetal Distress ◽  
Normal Pregnancy ◽  
Fetal Mortality ◽  
Medical College ◽  
Vertex Presentation

Aims & Objective: To find out the rate of vaginal delivery after one caesarean section Study Design: Non-interventional, descriptive study Study Setting: Department of Obstetrics & Gynaecology, Allama Iqbal Medical College and Jinnah Hospital, Lahore. Materials and Methods: A trial of vaginal delivery was carried out on 100 patients with previous one caesarean section. Selection criteria were subjects with normal pregnancy, adequate maternal pelvic dimensions vertex presentation and spontaneous onset of labour with previous one uncomplicated LSCS. Patients with classical caesarean section, medical complications, multiple pregnancy, IUGR, placenta previa and extensive myomectomy were excluded from the study. Informed consent was taken from all patients; trail of scar was given with vigilance. Maternal and fetal monitoring was carried out with facility of operation theatre, anaesthesia and paediatrician. Results: Majority of patients was between 20-24 years of age. 58% of the patients were primipara. Successful vaginal delivery was achieved in 72% and rate of repeat section was 28%. Leading indications for repeat section were failure to progress, (50%), fetal distress (28.5%) and scar tenderness (21.43%). No maternal & fetal mortality occurred. Conclusion: Trial of scar after one LSCS should be encouraged with vigilant monitoring provided no obstetric contraindication exists.

Near miss: a clinical case of a successful childbirth in a pregnant woman with Vasa Previa

2019 ◽  
Vol 17 (4) ◽  
pp. 107-110
Author(s):  
O. A. Toktarova ◽  
◽  
R. S. Zamaleeva ◽  
E. Yu. Yupatov ◽  
◽  
...  
Keyword(s):  
Pregnant Woman ◽  
Clinical Case ◽  
Near Miss ◽  
Vasa Previa

Clinical case of periostitis in pregnant women complicated by sepsis

2020 ◽  
pp. 61-63
Author(s):  
S. Sh. Kakvaeva ◽  
M. A. Magomedova ◽  
A. N. Dzhalilova
Keyword(s):  
Pregnant Woman ◽  
Multiple Organ Failure ◽  
Pregnant Women ◽  
Organ Failure ◽  
Clinical Case ◽  
Clinical Observation ◽  
Infectious Agent ◽  
Modern Medicine ◽  
Multiple Organ ◽  
Number Of Patients

One of the most serious problems of modern medicine is sepsis. The number of patients undergoing this complication is 20–30 million (WHO) annually and has no tendency to decrease. Sepsis is characterized by severe multiple organ failure due to a violation of the response of the macroorganism to an infectious agent. Moreover, it is dangerous with high mortality. Sepsis often develops in patients with immunodeficiency conditions, which primarily include pregnant women. The article presents a clinical observation of a case of periostitis in a pregnant woman complicated by a septic state.

Prenatal ultrasound diagnosis of velamentous insertion of the umbilical cord: clinical cases and literature review

2018 ◽  
Author(s):  
M.A. Esetov , A.M. Esetov , I.V. Ramazanova
Keyword(s):  
Umbilical Cord ◽  
Color Doppler ◽  
Color Doppler Ultrasound ◽  
Ultrasound Diagnosis ◽  
Cesarean Sections ◽  
Previous Cesarean Section ◽  
Vasa Previa ◽  
Obstetrical Management ◽  
Previous Cesarean ◽  
Singleton Pregnancies

Seven cases of ultrasound diagnosis of velamentous insertion (VCI) of the umbilical cord at singleton pregnancies on 21–34 weeks of gestation are presented. The ultrasound picture two of the VIC types is presented: fixed in 5 cases and free in 2 cases. In one case the VCI was in the lower third of the uterus and the wound has been diagnosed the vasa previa. In other cases, the VCI was in middle third of the uterus. In all cases delivery was at 37–39.1 weeks of gestation. In 4 cases Cesarean sections were performed. In two of the VCI cases elective Ce sarean sections were performed for the following indications: previous Cesarean section and vasa previa. VCI can reliably be detected prenatally by gray-scale and color Doppler ultrasound. For fixed VCI located in the middle-upper of the uterus, no change in standard obstetrical management seems to be required.

Congenital optic disc coloboma

2021 ◽  
pp. 33-39
Author(s):  
A.O. Nazarenko ◽  
◽  
E.E. Sidorenko ◽  
D.V. Miguel ◽  
A.S. Smartsev ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Optic Nerve ◽  
Clinical Picture ◽  
Clinical Case ◽  
Charge Syndrome ◽  
Diagnostic Methods ◽  
Newly Diagnosed ◽  
Optic Nerve Atrophy ◽  
Optic Disc Coloboma ◽  
Optic Nerve Coloboma

A clinical case of observation of a 3-year-old child with a newly diagnosed optic nerve coloboma and multiple malformations is considered. The clinical picture and diagnostic methods necessary for the diagnosis are reflected. On the example of this child, the differential diagnosis with Charge syndrome is considered. Key words: coloboma, optic nerve coloboma, partial optic nerve atrophy, astigmatism, Charge syndrome.

Cholangiocarcinoma in pregnancy (clinical case)

2020 ◽  
pp. 19-27
Author(s):  
A. Yu. Ralnikova ◽  
V. F. Bezhenar ◽  
B. V. Arakelyan ◽  
N. A. Tatarova ◽  
M. E. Malysheva
Keyword(s):  
Pregnant Woman ◽  
Clinical Case ◽  
Clinical Observation ◽  
Late Diagnosis ◽  
Biliary Cancer ◽  
In Pregnancy

The article discusses the problems of diagnosing biliary cancer during pregnancy, proceeding under the guise of complications associated with gestation. A clinical observation of late diagnosis of cholangiocarcinoma in a pregnant woman is presented.

scholarly journals Endometriosis as a Reason of Intraabdominal Bleeding in Pregnancy. Clinical Case

2019 ◽  
Vol 23 (3) ◽  
pp. 283-289
Author(s):  
Y. A. Revzoeva ◽  
E. Y. Shakurova
Keyword(s):  
Cesarean Section ◽  
Pregnant Women ◽  
Laboratory Tests ◽  
Clinical Case ◽  
Abdominal Cavity ◽  
Diagnostic Procedures ◽  
Reproductive Period ◽  
Diagnostic Methods ◽  
Dark Blood ◽  
Abdominal Bleeding

The article defines the significance and relevance of the problem of endometriosis during pregnancy. 10% of women in the reproductive period have different localization of endometriosis. 25% of pregnancies with endometriosis are complicated by preterm labor. The article presents a clinical case of intra-abdominal bleeding in a 28-year-old pregnant woman with retrocervical endometriosis at gestation age of 32 weeks and 6 days. The article covers the results of examination and special diagnostic procedures of intra-abdominal bleeding in pregnant women with retrocervical endometriosis. The main diagnostic methods were the study of past medical history, ultrasound examination, and laboratory tests. Due to their infrequency during pregnancy internal bleedings present difficulties in their diagnosis. Ultrasound reliably revealed a large amount of fluid in the abdominal cavity and small pelvis and excluded the presence of intrauterine bleeding. Clinical and laboratory tests indicated the severity of the patient's condition. Symptoms of moderate fetal distress were also identified. Therefore, a decision was made about an emergency delivery by the cesarean section followed by an abdominal revision. During the cesarean section, 500 ml of blood in the form of dark blood clots was found in the abdominal cavity. The condition of the premature newborn was in conformity with his gestational age. The source of bleeding were the of endometriosis on the back wall of the uterus. These focuses most likely caused hemoperitoneum. The revision of the abdominal cavity did not find any other foci of bleeding. The postoperative period was uneventful. The article provides general guidelines for the management of pregnant women with severe forms of endometriosis.

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