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In pregnancies with vasa previa, prenatal diagnosis and pre-labor cesarean delivery are associated with significantly improved perinatal outcomes compared to undetected cases. However, a universally accepted ultrasonographic definition of vasa previa is lacking. Specifically, the distance from the cervical internal os beyond which vaginal delivery can be safely recommended remains to be determined. Field experts and recently published societal guidelines agree that a 2 cm cut-off is suboptimal, given that complete cervical dilation during labor risks unprotected fetal vessels within a 5 cm radius from the internal os. Thus, in the setting of a scarcity of evidence and case reports of perinatal death with unprotected fetal vessels beyond 2 cm from the internal os, a more conservative definition that includes unprotected fetal vessels located within 5 cm of the internal os is imperative to improve outcomes.
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http://dx.doi.org/10.3390/jcm14031009 | DOI Listing |
Am J Obstet Gynecol
August 2025
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Fetal Care and Surgery Center (FCSC), Division of Maternal-Fetal Medicine and Surgery, Boston Children's Hospital, Boston, MA,
Objective: To evaluate the prenatal detection of vasa previa (VP) and perinatal survival in studies that implemented standardized protocols of prospective second-trimester ultrasound screening protocols followed by ultrasound confirmation in the third trimester.
Data Sources: PubMed/MEDLINE, Web of Science, EMBASE, Global Health, and Global Index Medicus were searched from inception to February 16, 2024.
Study Eligibility: We included cohort studies that implemented standardized second-trimester ultrasound protocols - either universal or targeted - for VP screening, with third-trimester ultrasound confirmation and verification at delivery, over at least one year.
Magn Reson Med Sci
August 2025
Department of Diagnostic Radiology, Tohoku University Hospital, Sendai Miyagi, Japan.
The umbilical cord and placenta, classified as fetal appendages, play a crucial role in fetal growth and survival. While ultrasonography remains the primary modality for evaluation, MRI provides a more objective and comprehensive assessment, particularly for the placenta and fetus. Although MRI assessment of the umbilical cord is still emerging and not yet widely adopted by radiologists, MRI has the potential to support and complement ultrasound findings, thereby contributing to safer perinatal management.
View Article and Find Full Text PDFEur J Obstet Gynecol Reprod Biol
July 2025
Department of Obstetrics and Gynecology, Jichi Medical University, 3311-1 Shimotsuke, Tochigi 329-0498, Japan.
Objective: To clarify whether the maternal backgrounds and perinatal outcomes of the three types of vasa previa (VP) differ based on placental location and cord insertion.
Methods: A retrospective questionnaire survey of VP cases in all 408 perinatal centers in Japan was conducted. The survey covered the clinical information of VP cases, including maternal characteristics, prenatal management, and perinatal outcomes, between January 2020 and December 2022.
Eur J Obstet Gynecol Reprod Biol
August 2025
Amsterdam University Medical Centers, Department of Obstetrics, Meibergdreef 9, P.O. box 22660, 1100 DD Amsterdam, the Netherlands.
Objectives: To quantify the risk of intrauterine fetal death (IUFD) associated with isolated velamentous cord insertion (VCI) and identify subgroups at increased risk to guide clinical management.
Methods: We conducted a retrospective case-control study and a systematic review with meta-analysis. The case-control study included singleton pregnancies with VCI and no fetal anomalies diagnosed at Amsterdam UMC (2007-2024), matched 1:2 to controls without VCI or anomalies, based on year of detection and scan type.
Taiwan J Obstet Gynecol
July 2025
Department of Fetal Medicine, Taiji Clinic, Taipei, Taiwan. Electronic address: