Diagnosis and management of vasa previa: a questionnaire survey.

Abstract

OBJECTIVES:

Our aim was to assess the current use of obstetric ultrasound imaging for the diagnosis of asymptomatic vasa previa. We also investigated obstetricians' views on the feasibility of a screening policy and their awareness of risk factors associated with this condition.

METHODS:

A national postal survey was conducted between March and July 2006. A total of 234 questionnaires were sent to obstetric and fetomaternal consultants across England and Wales. In all, 128 questionnaires were returned, a response rate of 55%.

RESULTS:

Most respondents (85%) stated that in their hospital they do not report velamentous cord insertions at the anomaly scan. However, 73% occasionally or routinely document the presence of succenturiate lobes. Only 33% of respondents offered transvaginal scanning for the identification of vasa previa within their hospital, whereas only 6% had ever referred women to a tertiary center for this indication. In all, 34% of the respondents did not identify any risk factor for the condition. Most respondents (80%) would offer an elective Cesarean section if vasa previa was suspected antenatally; the majority would perform it at 38 weeks' gestation. However, only 20% of respondents felt that an effective screening policy is possible.

CONCLUSIONS:

Despite evidence that perinatal death can be prevented by antenatal diagnosis of vasa previa, most obstetricians in England and Wales feel that a screening policy is not possible. The majority of them would offer an elective Cesarean section for vasa previa at around 38 weeks. There is a need to increase awareness and understanding of the major risk factors for this condition.

• Authors: C Ioannou, C Wayne
• Journal: Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology (Ultrasound Obstet Gynecol) Vol. 35 Issue 2 Pg. 205-9 (Feb 2010) ISSN: 1469-0705 [Electronic] England
• PMID: 20014327 (Publication Type: Evaluation Study, Journal Article)

Topics

• England (epidemiology)
• Feasibility Studies
• Female
• Gestational Age
• Health Care Surveys
• Humans
• Obstetrics (statistics & numerical data)
• Placenta Diseases (diagnostic imaging, epidemiology, therapy)
• Practice Patterns, Physicians' (statistics & numerical data)
• Pregnancy
• Referral and Consultation (statistics & numerical data)
• Risk Factors
• Surveys and Questionnaires
• Ultrasonography, Prenatal
• Vasa Previa (diagnostic imaging, epidemiology, therapy)
• Wales (epidemiology)