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CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
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Poster Session 3

(723) Delivery and neonatal outcomes of resolved vasa previa cases

Friday, January 31, 2025
10:30 AM – 12:30 PM  
Objective: Recent expert opinion has questioned the definition of vasa previa. We examined delivery and neonatal outcomes in cases of resolved vasa previa, comparing fetal vessels 2-5cm from the cervical os versus >5cm away from the os.

Study Design: Retrospective cohort study of patients diagnosed with vasa previa at a single academic urban institution between 2004 to 2024. We conducted an electronic chart review, including ultrasound images, to obtain variables at diagnosis and throughout pregnancy, along with delivery and neonatal outcomes. We used descriptive and chi-square statistics.

Results: We identified 112 pregnancies with vasa previa, of which 31 (28%) resolved on a subsequent ultrasound. Of the 31 resolved vasa previa cases, 20 were 2-5cm from the os and 11 were >5cm. Of those with vessels 2-5cm from the cervical os, 9 (45%) delivered by scheduled cesarean and 11 (55%) had a trial of labor (TOL). Of those that had a TOL, five (45%) delivered vaginally and six (55%) had a cesarean delivery due to PPROM (n=2), fetal intolerance of labor (n=1), arrest of descent (n=1), unstable lie (n=1) and worsening pre-eclampsia (n=1). Of those with vessels >5cm from the os, one (9%) delivered by scheduled cesarean and 10 (91%) had a TOL, of which 8 (80%) delivered vaginally. The only emergent cesarean delivery and neonatal blood transfusion occurred in a patient with fetal vessels >5cm from the os; the suspected etiology was placental abruption. There were no statistically significant differences in neonatal APGAR scores, umbilical artery pH and intensive care nursery admissions between groups. There were no perinatal deaths.

Conclusion:

The majority of resolved vasa previa cases with vessels 2-5cm from the cervical os delivered by cesarean. While many were scheduled, there were urgent cesareans for PPROM, unstable lie, arrest of descent, worsening pre-eclampsia and fetal intolerance. Most cases with vessels >5cm from the os delivered vaginally. Larger studies are needed to further assess delivery and neonatal outcomes of resolved vasa previa.