VISUOG offers accurate, peer-reviewed, and evidence-based visual chapters covering a range of pregnancy and gynecological conditions. Detailed anatomical visualisations are provided to enhance diagnostic accuracy and understanding of the implications for sonographic screening of vasa previa.

Vasa previa is a rare condition, occurring in approximately 1 in 1,300 to 1 in 2,500 deliveries. It can lead to perinatal mortality upon the rupture of the fetal membranes. However, the survival rate has increased to up to 97% due to prenatal diagnosis.

Vasa previa should be clinically suspected in a patient who presents with vaginal bleeding and abnormal fetal heart tracings (sinusoidal patterns or bradycardia) after rupture of the membranes.

This chapter provides a comprehensive insight into the diagnosis of the condition, emphasizing the significance of prenatal detection. Current literature demonstrates that prenatal diagnosis significantly increases the survival rate to 97-100%, with perinatal mortality decreasing to less than 10%, compared to pregnancies where the diagnosis is missed.

The chapter emphasizes that there is no consensus on the optimal management protocols for prenatally diagnosed cases of vasa previa. Current recommendations are based on small case series, expert opinions, and clinical judgment, as there are no clinical trials available. The chapter highlights certain guidelines on management by the Society of Obstetricians and Gynaecologists of Canada (SOGC) and presents similar recommendations as suggested by The Royal College of Obstetricians and Gynaecologists (RCOG).

When vasa previa is detected in the intrapartum period, there is a high risk of fetal exsanguination, stillbirth, and neonatal death, with potential morbidity in survivors. Therefore, it is crucial to diagnose the condition promptly.

This chapter is valuable for exploring the implications of sonographic screening. It highlights that the combined use of transabdominal and transvaginal Doppler sonography provides the highest diagnostic accuracy with low false positive rates.

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