Vasa previa

Fabrice Cuillier, MD

Service de Gynécologie-Obstétrique, Hôpital Félix Guyon, Saint-Denis de La Réunion, France.

Case report

A 30-year-old healthy woman, G3 P2, was referred to our unit for the ultrasound examination at 32 weeks of gestation.

The ultrasound examination of the fetus was normal. Examination of the placenta and umbilical cord showed a bilobate placenta with a velamentous cord insertion.

On the ultrasound examination at 34 weeks of gestation, we have seen bilobate placenta on the anterior and posterior uterine wall. The placental vessels traversed the lower uterine segment and the internal cervical os. This finding was suggestive of the vasa previa.

Patient delivered via cesarean section at 37 weeks of gestation. The examination of the placenta confirmed our prenatal ultrasound findings of bilobate placenta with velamentous cord insertion.

Images 1,2: Images show the lower uterine segment. Placental vessel is near the internal cervical os and is below the head, the presenting part.

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Vasa_praevia_2

Images 3,4: Image 3 shows the color Doppler of the vessel, the frequency differentiates the placental vessels from maternal uterine vessels. In this case, this was consistent with frequency of the fetal heart beat. Image 4 shows a 3D rendering of the vessel.

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Images 5,6: Images of the placenta, note the velamentous cord insertion.
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