You're so excited about becoming a mother, but sometimes you feel a little scared about the little things, right? That's normal. Today we're going to talk about a condition that can occur during pregnancy, which is a bit rare, but can be managed well if you know about it in advance. This is called Vasa Previa. Don't worry, we'll talk about it in detail.
What is Vasa Previa? Let's understand it simply!
Simply put, Vasa Previa is a complication that can occur during pregnancy. This is when some of the blood vessels in the umbilical cord, which carry nutrients to your baby, pass unprotected through the cervix. Normally, these blood vessels are well-protected by the placenta.
Imagine, when labor begins, when the amniotic sac breaks, these unprotected blood vessels right at the cervix can burst. If that happens, the baby could bleed profusely and even die. However, if this condition is recognized early and managed properly, especially if the baby is delivered by cesarean section (`C-section`), this risk can be completely avoided. That's why it's important to be aware of this.
There are two main types of Vasa Previa:
Doctors divide this condition into two main types. Let's see what they are.
1. Type 1: Vesa Previa with Velamentous Cord Insertion
This may sound like a complicated name, but it's not hard to understand. Velamentous cord insertion is when the umbilical cord is not directly attached to the placenta, but rather has its blood vessels running outside the placenta, unprotected. Normally, the umbilical cord is attached directly to the placenta.
Now imagine, if there is an unprotected blood vessel like this, located at the bottom of the uterus, close to the cervix (this is called a `low-lying placenta`), when labor begins and the baby moves towards the cervix, there is a much higher chance that that blood vessel will stretch and burst.
2. Type 2: Vesa Previa with Bilobed Placenta
This is when your placenta is not a single piece, but is divided into two lobes, like two lungs. The umbilical cord can then connect these two parts. If the unprotected blood vessels between these two parts pass close to the cervix, they can rupture when labor begins.
What is the difference between Vasa Previa and Placenta Previa?
These two names are somewhat similar, so they can be confused. But these two refer to two different situations.
- Placenta Previa is when the placenta is located lower in the uterus, covering all or part of the cervix, instead of at the top. When labor begins, the blood vessels connecting the placenta to the uterus can stretch and bleed.
- Importantly, if you have placenta previa and it later resolves (resolved placenta previa) or has a low-lying placenta, the risk of developing vasa previa increases. This means that there may be a link between these two conditions.
How serious is Vasa Previa?
In fact, vesa previa is a serious condition that needs to be taken care of. If not detected early, the baby may even be born as a stillbirth.
But, remember this: If this condition is diagnosed during pregnancy (prenatal diagnosis), treated properly, and delivered by a planned cesarean section (C-section), the baby has a 98.6% chance of survival!
Therefore, instead of being afraid, the most important thing is to be properly informed and follow medical advice.
Who is most affected by this condition? (Risk factors)
People who are more likely to develop Vasa Previa are:
- If you have conditions such as `velamentous cord insertion` (the umbilical cord does not attach properly to the placenta) or `bilobed/multilobed placenta` (the placenta is divided into several parts).
- If your placenta is located low in the uterus, completely or partially covering the cervix (`placenta previa` or `low-lying placenta`).
- If you have had a previous cesarean section (C-section).
- If you are pregnant through in vitro fertilization (IVF - In Vitro Fertilization).
- If you are expecting twins or triplets (`multiples`).
- If you have had previous uterine surgeries.
If you have these risk factors, your doctor will pay more attention to them.
How common is Vasa Previa?
This is a very rare condition. It usually occurs in about one in 2,500 births. However, in cases of in vitro fertilization (IVF), the incidence is slightly higher, at about one in 200 births.
What are the symptoms of Vasa Previa?
Often, a mother with vasa previa may not show any symptoms. That's why ultrasound scans during pregnancy are so important. Doctors can diagnose the condition through these scans.
However, very rarely, some people may experience a small amount of vaginal bleeding during the second or third trimester of pregnancy without any pain. This blood may be a slightly darker red than normal. It may not be your blood, but rather a sign of fetal blood. If you experience vaginal bleeding at any time during pregnancy, whether with or without pain, see your doctor immediately, no matter how small.
What causes Vasa Previa?
The main reason for this is, as mentioned earlier, that the umbilical cord blood vessels that connect you and your baby pass unprotected near the cervix. Normally, the umbilical cord is directly connected to the placenta, and the blood vessels are well protected. However, in vesa previa, not only does this blood vessel protrude, but it also lies close to the cervix, which is the area most likely to be squeezed during childbirth.
How is Vasa Previa diagnosed?
Vesa previa is usually diagnosed during an ultrasound scan between 18 and 26 weeks of pregnancy. If your scan shows risk factors for vasa previa, such as a bilobed placenta or velamentous cord insertion, your doctor may do a special ultrasound scan through your vagina (transvaginal ultrasound) . This can clearly see if there are blood vessels in the umbilical cord near the cervix (cervical os). Sometimes doctors also use an ultrasound technique called color Doppler . This shows the blood flow in colors, making it easier to identify the location of the blood vessels.
The doctor will specifically look for these things:
- Where is the placenta located in relation to the cervix?
- Whether the placenta has multiple lobes.
- Where the umbilical cord is located.
What are the treatments for Vasa Previa?
If you are diagnosed with vasa previa, your doctor will likely decide to deliver your baby by planned cesarean section (C-section). They will also monitor you and your baby closely throughout your pregnancy. The doctors' main goal here is to keep the baby in the womb for as long as possible, but also to start labor as soon as possible and deliver the baby safely before the blood vessels are damaged.
Your pregnancy plan may include:
- Non-stress tests: These tests are performed about twice a week to check the baby's heartbeat. They are completely safe for both you and your baby.
- Corticosteroids: These medications can be given before a cesarean section to help the baby's lungs develop properly. This is because, since the baby may need to be delivered a little early, lung maturation is important.
- Inpatient management: Your doctor may decide to keep you in the hospital for close observation for a few days before your baby is born. This decision will be made based on factors such as your pre-existing medical conditions, the likelihood of early labor, and how far you live from the hospital.
- Planned cesarean section (between 34 and 37 weeks): Your doctor will talk to you about the best time to deliver your baby to minimize complications associated with vesa previa. Since the baby is often delivered a little early, the baby may need to be cared for in the Neonatal Intensive Care Unit (NICU) after birth.
Your specific pregnancy plan will be determined by your situation, so it's important to follow your doctor's instructions exactly.
Can Vasa Previa be "fixed"?
Actually, there's no way to "fix" a condition called vesa previa. That is, you can't change the way the blood vessels are. But you can manage the condition and create a plan to successfully deliver a healthy baby. Talk to your doctor about the best time to deliver your baby safely for both you and your baby, and when to have a cesarean section.
Can the risk of Vasa Previa be reduced?
You can't reduce the risk of developing vesa previa. It's not something we can control. But, you can reduce the risk of the most serious complications that can arise from it. How can you do that? By attending regular prenatal clinics and following your doctor's advice. Early detection of this condition is the key to achieving the best results.
If I have a vasa previa, what should I expect?
If you have vasa previa, you should expect a cesarean section (C-section) instead of a vaginal delivery. You will also need to undergo additional monitoring tests throughout your pregnancy. This extra care will help you deliver a healthy baby.
Does Vasa Previa affect the baby?
How the condition affects the baby depends on how early it is detected. If vasa previa is not detected, the fetal mortality rate can be as high as 56% to 60%. However, if it is detected early in pregnancy, managed properly, and delivered by cesarean section, the baby has a 97% chance of survival. In some cases, the baby may need additional care in the NICU after birth, especially if the baby is born prematurely. However, the outcomes of cesarean sections with vasa previa are very good.
When should I see my doctor?
See your doctor on a regular basis throughout your pregnancy. Also, attend all recommended ultrasound scans. If you are diagnosed with vesa previa, you may need to see your doctor more often.
If you notice vaginal bleeding during the second or third trimester of your pregnancy, see your doctor immediately. If the bleeding is heavy, go to the nearest hospital emergency department immediately.
What questions should I ask my doctor?
If you have vesicoureteral reflux, ask your doctor how to reduce the risk of serious complications. For example:
- "Is it better for me to abstain from sex (pelvic rest)?"
- "What habits can I adopt to have a healthy pregnancy?"
Having complications during pregnancy is scary. But that doesn't mean you can't have a healthy pregnancy, delivery, and baby. Knowing that you have vasa previa is the first step to planning a successful cesarean section. Talk to your doctor about how your diagnosis will affect your birth plans.
Take-Home Message
Vasa Previa is a rare but serious condition that can occur during pregnancy.
- What happens in this case is that the baby's umbilical cord blood vessels pass through the cervix unprotected.
- Early detection is very important. Since there are often no symptoms, it is essential to go for regular scans.
- The main treatment is to deliver the baby by planned cesarean section (C-section).
- With early detection and proper management, the chance of saving the baby's life is very high (over 97%).
- Always talk to your doctor and follow their advice. Don't worry, you are not alone. With the right knowledge and medical support, you can cope with this condition successfully.
` Vasa Previa, pregnancy, pregnancy complications, umbilical cord, placenta, cesarean section, fetal health, prenatal diagnosis
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