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CME Credit Offered
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Abstract Award
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Poster Session 2

(621) Diagnosis of Vasa Previa: Is It Time to Sweep?

Thursday, January 30, 2025
4:00 PM – 6:00 PM  

    Submitting Author and Presenting Author(s)

  • Sami Backley, MD

    Clinical Fellow PGY 9
    Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
    Houston, Texas, United States

    • Coauthor(s)

  • Eric P. Bergh, MD

    Associate Professor
    Nemours Children's Health
    Wilmington, Delaware, United States

  • ES

    Eleazar E. Soto, MD

    Assistant Professor
    McGovern Medical School at UTHealth Houston
    Houston, Texas, United States

  • Neha Agarwal, MBBS, MD

    Post doctoral Research Fellow
    Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, UTHealth McGovern Medical School, Houston, TX, USA
    Houston, Texas, United States

  • Felicia V. LeMoine, MD (she/her/hers)

    Fetal Intervention Fellow
    Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
    Houston, Texas, United States

  • GV

    Gustavo Vilchez, MD, MSCR

    UTHealth Houston
    Houston, Texas, United States

  • Anthony Johnson, DO

    Professor
    McGovern Medical School University of Texas Health Science Center at Houston (UThealth)
    Houston, Texas, United States

  • Jimmy Espinoza, MD, MSc

    Professor
    Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
    Houston, Texas, United States

  • Edgar A. Hernandez-Andrade, MD, PhD (he/him/his)

    Professor
    McGovern Medical School at UTHealth Houston
    Houston, Texas, United States

  • AS

    Ashley Salazar, DNP

    Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UT Health Houston
    Houston, Texas, United States

  • Ramesha Papanna, MD, MPH

    Professor
    McGovern Medical School at UTHealth Houston
    Houston, Texas, United States

Objective: Undiagnosed vasa previa (VP) has devastating consequences due to fetal hemorrhage. Despite the evidence, there is a lack of screening guidelines. Utilizing the universal cervical length (CL) screening protocol at our center, the objective of the study was to identify and characterize the vasa previa distance from the internal os using color Doppler (CD) sweep on transvaginal ultrasound.

Study Design: This was a retrospective cohort study of singleton pregnancies that underwent universal transvaginal CL screening with CD, transvaginal sweep between 2016-2024. VP cases were identified from an ultrasound database query. The images/clips were analyzed using the following screening methods: 1) midline still image with CD, 2) CD sweep over the cervix, and 3) CD sweep to the lateral lower uterine segment (Fig 1A). Quantitative assessment was performed for vessel type (artery, vein or both), Doppler flow (cm/sec), and distance from the internal os (cm) for each image.

Results: 139 of 67,369 pregnancies with transvaginal CL had VP in the diagnostic field. 98 (0.14%) VP were diagnosed of which: 47 (45%) were Type 1, 33 (34%) were Type 2 and 21 (21%) were Type 3. Midline CD view alone diagnosed 32 (33%) of cases. CD flow over the cervix diagnosed an additional 39 (40%) cases. CD flow in the lateral lower uterine segment provided diagnosis of 27 (27%) additional cases. The incidence of resolving placenta previa and velamentous cord insertion were similar in all groups. VP type 3 was more likely to be diagnosed on lateral sweep (p = 0.02). The distance between the cervical os and the fetal vessel was further away in cases diagnosed on lateral sweep compared to midline view and midline CD sweep of internal cervical os (Fig 1B).

Conclusion: Color Doppler sweep of the cervix and lateral lower uterine segment identifies a higher proportion of vasa previa prenatally. Fetal vessels lateral to the cervix constitute 1 in 5 of vasa previa cases. Guidelines to standardize the screening for vasa previa to include lateral aspects of the cervix should be considered.