Prevention of stillbirths: impact of a two-stage screening for vasa previa
Zhang, W., Geris, S., Beta, J., Ramadan, G., Nicolaides, K. H. and Akolekar, R. 2019. Prevention of stillbirths: impact of a two-stage screening for vasa previa. Ultrasound in Obstetrics and Gynecology. 55 (5), pp. 605-612.
|Authors||Zhang, W., Geris, S., Beta, J., Ramadan, G., Nicolaides, K. H. and Akolekar, R.|
Objectives: To examine the feasibility and effectiveness of a two-stage ultrasound screening strategy for detection of vasa previa and estimate the potential impact of screening on prevention of stillbirth.
Methods: This was a retrospective examination of data from prospective screening for vasa previa in singleton pregnancies undertaken at the Fetal Medicine Centre at Medway Maritime Hospital, UK between 2012 and 2018. Women booked for prenatal care and delivery in our hospital had routine ultrasound examinations at 11-13 and 20-22 weeks’ gestation. Those with velamentous cord insertion at the inferior part of the placenta at the first-trimester scan and those with low-lying placenta at the second-trimester scan were classified as high-risk for vasa previa and had transvaginal sonography specifically searching for vasa previa at the time of the 20-22 weeks scan. The management and outcome of cases with suspected vasa previa is described. We excluded cases of miscarriage or termination at <24 weeks’ gestation.
Results: The study population of 26,830 singleton pregnancies, included 21 (0.08% or 1 in 1,278) with vasa previa. In all cases of vasa previa the diagnosis was made at the 20-22 weeks scan and confirmed by gross and histological examination of the placenta postnatally. At the 11-13 weeks
Conclusion: A two-stage strategy of screening for vasa previa can be incorporated into routine clinical practice and such strategy could potentially reduce the rate of stillbirth.
|Keywords||Vasa previa; Stillbirth; Velamentous cord insertion; Bilobed placenta; Adverse pregnancy outcome; First trimester ultrasound|
|Journal||Ultrasound in Obstetrics and Gynecology|
|Journal citation||55 (5), pp. 605-612|
|Digital Object Identifier (DOI)||doi:10.1002/uog.21953|
|Online||01 May 2020|
|Publication process dates|
|Accepted||03 Dec 2019|
|Deposited||18 May 2020|
Accepted author manuscript
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