Vasa previa

Background

• Fetal blood vessels from the umbilical cord run in close proximity to cervical os
  • Seldom recognized prior to vessel disruption

Risk Factors

• Placenta previa
• IVF
• Bilobed placenta

Diagnosis

• Painless bleeding occurs during SROM
  • Fetal in origin (mother's life is not at risk)
  • May lead to fetal exsanguination

Differential Diagnosis

Abdominal Pain in Pregnancy

The same abdominal pain differential as non-pregnant patients, plus:

<20 Weeks

• Ectopic pregnancy
• First trimester abortion
  • Complete abortion
  • Threatened abortion
  • Inevitable abortion
  • Incomplete abortion
  • Missed abortion
  • Septic abortion
• Round ligament stretching
• Incarcerated uterus
• Malposition of the uterus

>20 Weeks

• Labor/Preterm labor
• Placental abruption
• Placenta previa
• Vasa previa
• Uterine rupture
• Vaginal trauma
• HELLP syndrome
• Cholestasis of pregnancy
• Chorioamnionitis
• Incarcerated uterus
• Acute fatty liver of pregnancy
• Malposition of the uterus
• Placenta accreta
• Placenta increta
• Placenta percreta

Any time

• Hemorrhagic ovarian cyst
• Fibroid degeneration or torsion
• Ovarian torsion
• Constipation

Treatment

C-section

See Also

• Pregnant vaginal bleeding

Source

• Tintinalli

See Also

Vaginal Bleeding (Main)