Abstract
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.
Highlights
We present here a case of vasa previa in a multipara, diagnosed at the time of her late second trimester ultrasonogram
The condition carries a risk of fetal exsanguination and death when rupture of the membranes involves tearing of vasa previa vessels running within the membranes and carrying fetal blood
Nomiyama et al identified placental cord insertion site with great degree of certainty at 18-20 weeks gestation and Sepluveda confirmed that gray scale with color Doppler has significant and better accuracy in diagnosing potential abnormal cord insertion and exclude vasa previa than 3D3,4
Summary
The patient’s antenatal course was otherwise uneventful She was counseled for Cesarean delivery at 35–36 weeks to avoid the risk of inadvertent rupture of the vasa previa and fetal exsanguination[1,2]. She believed that considering given her past obstetrical history of post –term pregnancies and her closed long cervix, she is was less likely to go into preterm labor or sustain preterm premature rupture of membranes with a disastrous outcome secondary to vasa previa.
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