• Richard Bronsteen, Amy Whitten, Mamtha Balasubramanian, Wesley Lee, Robert Lorenz, Mark Redman, Luis Goncalves, David Seubert, Sam Bauer, and Christine Comstock.
• Department of Obstetrics and Gynecology and Research Institute, William Beaumont Hospital, Royal Oak, Michigan 48073, USA. rabronsteen@beaumont.edu
• Obstet Gynecol. 2013 Aug 1; 122 (2 Pt 1): 352-7.

ObjectiveTo review experience with diagnosis, clinical associations, and outcomes of vasa previa in a single institution.MethodsThis was a retrospective review of all identified vasa previa cases from January 1 1990, to June 30, 2010.ResultsSixty cases of vasa previa were identified (53 singletons, seven twins); 56 cases were diagnosed before delivery. An abnormal cord insertion or abnormal placental location was present in 55 cases. Missed diagnoses were attributed to technical and observer factors. Preterm bleeding was encountered in 25 (42%) case group participants. Seven case group participants required an emergent delivery, with significant neonatal morbidity and mortality. Twin pregnancies had a significantly earlier median age at delivery of 32 weeks of gestation compared with 35 weeks of gestations in singletons (P=.01). The seven twin pregnancies had a 28.6% emergent preterm delivery rate, whereas singletons had a 4.1% rate (P=.07). In 14 case group participants, the membranous fetal vessel was located in the lower uterus and not directly over the cervix. The vessel location was not related to the risk of emergent delivery.ConclusionTransvaginal ultrasound scans of at-risk patients can identify most cases of vasa previa. Preterm bleeding does not usually require immediate delivery. The rate of emergent preterm delivery was low in singleton pregnancies. Twins were delivered, on average, 3 weeks earlier than singletons.Level Of EvidenceIII.

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