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Cited by 88Maternal and fetal healthcarePregnancy and preeclampsia studiesCongenital Anomalies and Fetal Surgery

Vasa Praevia: Diagnosis and Management: Green‐top Guideline No. 27b

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Jauniaux, ERM, Alfirevic, Z, Bhide, AG, Burton, GJ, Collins, SL, Silver, R, the Royal College of Obstetricians and Gynaecologists·2019·BJOG: An International Journal of Obstetrics & Gynaecology
DOI 10.1111/1471-0528.15307
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Abstract

This is the fourth edition of this guideline.The first, published in 2001, was entitled Placenta Praevia: Diagnosis and Management; the second, published in 2005, was entitled Placenta Praevia and Placenta Praevia Accreta: Diagnosis and Management; and the third, published in 2011, was entitled Placenta Praevia, Placenta Praevia Accreta and Vasa Praevia: Diagnosis and Management.The management and diagnosis of placenta praevia and placenta accreta is addressed in Green-top Guideline No. 27a. Executive summary Management of women with undiagnosed vasa praevia at deliveryEmergency caesarean delivery and neonatal resuscitation, including the use of blood transfusion if required, are essential in the management of ruptured vasa praevia diagnosed during labour. BPlacental pathological examination should be performed to confirm the diagnosis of vasa praevia, in particular when stillbirth has occurred or where there has been acute fetal compromise during delivery.[New 2018] P Can vasa praevia be diagnosed antenatally?The performance of ultrasound in diagnosing vasa praevia at the time of the routine fetal anomaly scan has a high diagnostic accuracy with a low false-positive rate.[New 2018] B A combination of both transabdominal and transvaginal colour Doppler imaging (CDI) ultrasonography provides the best diagnostic accuracy for vasa praevia. D Should we screen for vasa praevia?There is insufficient evidence to support universal screening for vasa praevia at the time of the routine midpregnancy fetal anomaly scan in the general population. DAlthough targeted midpregnancy ultrasound screening of pregnancies at higher risk of vasa praevia may reduce perinatal loss, the balance of benefit versus harm remains undetermined and further research in this area is required.[New 2018

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  • There is ongoing debate regarding whether routine screening for velamentous cord insertion and/or vasa previa should be performed at the mid-trimester scan; the evidence is of limited quality and fails to take into account the consequences of over-diagnosing such anomalies.

    “There is, however, ongoing debate regarding whether routine screening for velamentous cord insertion and/or vasa previa should be performed at the mid-trimester scan; the evidence is of limited quality and fails to take into account the consequences of over-diagnosing such anomalies 47,88 .”

    From <scp>ISUOG</scp> Practice Guidelines (updated): performance of the routine mid‐trimester fetal ultrasound scan (2022) · cites this paper as [88]

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Research works printed but not linked: 3

  1. Fox H, Sebire NJ, editors. Pathology of the Placenta. 3rd ed. Philadelphia, PA: Saunders-Elsevier; 2007.
  2. Oyelese YO, Turner M, Lees C, Campbell S. Vasa previa: an avoidable obstetric tragedy. Obstet Gynecol Surv 1999;54:138- 45.
  3. UK National Screening Committee. Screening for Vasa Praevia in the Second Trimester of Pregnancy. External Review Against Programme Appraisal Criteria for the UK National Screening Committee (UK NSC). London: UK NSC; 2017.

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Authors
Jauniaux, E., Alfirevic, Z., Bhide, A., Burton, G., Collins, S., Silver, R., & the Royal College of Obstetricians and Gynaecologists
Affiliations
Royal College of Obstetricians and Gynaecologists (GB)
ORCID
Silver, R
Venue
BJOG: An International Journal of Obstetrics & Gynaecology
Publisher
Wiley
Published
2018-09-27
Volume
126
Issue
1
Pages
e49-e61
ISSN
  • 0306-5456 (ISSN-L)
  • 1470-0328
  • 1471-0528
DOI
10.1111/1471-0528.15307
OpenAlex
W2892398433
Cited by
88
References
35
Citations by year
2026: 7 · 2025: 9 · 2024: 14 · 2023: 12 · 2022: 14 · 2021: 13 · 2020: 7 · 2019: 10 · 2018: 1
FWCI
8.56
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • BJOG An International Journal of Obstetrics & Gynaecology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
  • Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
  • Health Sciences › Medicine › Surgery › Congenital Anomalies and Fetal Surgery
Keywords
vasa previa, prenatal diagnosis, colour Doppler ultrasonography, transvaginal ultrasound, fetal anomaly scan, emergency caesarean delivery, neonatal resuscitation, placental pathology, targeted screening, perinatal loss
MeSH terms
Adrenal Cortex Hormones, Cesarean Section, Female, Humans, Pregnancy, Risk Factors, Uterine Hemorrhage, Ultrasonography, Prenatal, Ultrasonography, Doppler, Color, Premature Birth, Stillbirth, Vasa Previa

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