O69.4

Clinical Causes: Velamentous cord insertion: When the umbilical cord inserts into the fetal membranes instead of the placenta, increasing risk. Succenturiate placentas: The presence of accessory lobes that can lead to abnormal blood vessel placement. Multiple pregnancies: Higher likelihood of placental and vessel abnormalities. In vitro fertilization (IVF): Assisted reproductive techniques have been associated with increased risk. Previous pregnancy complications: A history of placental abnormalities can elevate risk. Abnormal placental attachment types: Such as placenta previa or succenturiate lobes.

Key Symptoms: No specific symptoms during pregnancy; often detected prenatally through ultrasound. In cases of labor onset, signs of fetal distress, such as abnormal fetal heart rate patterns. Potential bleeding episodes if blood vessels rupture during pregnancy or labor. Signs of fetal anemia or distress post-rupture, requiring immediate attention.

Diagnosis Path: Vasa previa is primarily diagnosed through detailed ultrasound examinations, particularly with color Doppler imaging, which can visualize fetal blood vessels over the cervical opening. Prenatal screening in the second trimester is common for at-risk pregnancies, enabling planning for delivery. Sometimes, additional imaging tests or procedures like fetal echocardiography are used to assess fetal well-being.

Treatment Protocols: Management focuses on preventing vessel rupture during labor. The standard approach often includes scheduling a cesarean section before labor begins, typically around 34-37 weeks of pregnancy. Hospitalization may be advised in the weeks leading up to delivery for close monitoring. During delivery, careful planning ensures that obstetric and neonatal teams are prepared for potential bleeding and to provide immediate care to the newborn if needed. In some cases, bed rest or corticosteroid administration can be recommended to enhance fetal lung maturity. Post-delivery evaluation ensures any hemorrhage has been controlled and both mother and baby are stable.