Vasa previa occurs when fetal membranes, are with fetal blood vessels that connect the umbilical cord and the placenta to the internal os.
A Vasa previa can independently or placental abnormalities such. B. Insertio velamentosa occur. In Insertio velamentosa vessels leading from the umbilical cord through part of the chorionic membrane rather than directly into the placenta (vasa praevia.). Thus, the blood vessels are not protected by Wharton’s jelly within the navel so that there is more of a fetal blood flow during a rupture of the fetal membranes.
Vasa previa occurs when fetal membranes, are with fetal blood vessels that connect the umbilical cord and the placenta to the internal os. A Vasa previa can independently or placental abnormalities such. B. Insertio velamentosa occur. In Insertio velamentosa vessels leading from the umbilical cord through part of the chorionic membrane rather than directly into the placenta (vasa praevia.). Thus, the blood vessels are not protected by Wharton’s jelly within the navel so that there is more of a fetal blood flow during a rupture of the fetal membranes. The prevalence is about 1 in 2500-5000 births. If the vasa praevia not diagnosed before birth, the fetal mortality rate can be as high as 60%. Vasa previa. Symptoms and complaints Classically, it manifests itself by painless vaginal bleeding, rupture and fetal bradycardia. Diagnostic Transvaginal sonography A suspected diagnosis should be made due to the clinic or the findings of prenatal routine ultrasound examination. During the first presentation the fetal, mostly sinusoidal heart rate pattern is usually noticeable. The diagnosis can usually be confirmed by transvaginal sonography. The fetal vessels can be seen in the fetal membranes, as they pass directly over the internal os. Flow mapping color Doppler can be used in addition. Vasa previa has the existence of the umbilical cord (prolapse of the umbilical cord between the fetus and inner cervix) are deferred, in which the surrounded by Wharton’s jelly fetal blood vessels are seen as they cover the cervix. Prenatal treatment Nonstress test to detect an umbilical cord compression cesarean Prenatal treatment of vasa previa is controversial, among other reasons, also because randomized clinical studies are lacking. beginning with the 28th-30 at most centers. performed SSW 2 times per week Nonstress test. The goal is to detect a compression of the umbilical cord. Frequently continuous monitoring or testing Nonstress is every 6-8 hours, starting at about 30-32. SSW offered. Corticosteroids can accelerate fetal lung maturity. If it comes to premature rupture of membranes, vaginal bleeding stops or fetal status is striking is usually displayed an emergency caesarean section. If none of these symptoms is present and has not yet begun the birth, a planned caesarean section can be offered; Tests to assess fetal lung maturity (which usually takes place between the 32nd and 35th week of pregnancy) can be performed to determine the delivery date.