gynecology and obstetrics
Vasa Previa
Treatment of Vasa Previa
Prenatal monitoring to detect cord compression Cesarean delivery Prenatal management of vasa previa is controversial, partly because randomized clinical trials are lacking. At most centers, nonstress testing is done twice a week beginning at 28 to 30 weeks. The purpose is to detect compression of the umbilical cord. Admission for continuous monitoring or for nonstress testing every 6 to 8 hours at about 30 to 32 weeks is often offered. Corticosteroids are used to accelerate fetal lung maturity. Emergency cesarean delivery is usually indicated if any of the following occurs: Premature rupture of the membranes occurs. Vaginal bleeding continues. Fetal status is nonreassuring If none of these problems are present and labor has not occurred, clinicians can offer to schedule cesarean delivery. Cesarean delivery between 34 to 37 weeks has been suggested, but the timing of delivery is controversial; some evidence favors delivery at 34 to 35 weeks ( Treatment reference ). 1.American College of Obstetricians and Gynecologists’ Committee on Obstetric Practice, Society for Maternal-Fetal Medicine: Medically indicated late-preterm and early-term deliveries: ACOG Committee Opinion, Number 831.Obstet Gynecol138 (1):e35–e39, 2021. doi: 10.1097/AOG.0000000000004447 