Management and mode of delivery in vasa praevia
Aim. To evaluate pregnancy outcomes and features of delivery of pregnant women with VP. Materials and Methods. This article presents a retrospective study of the course of pregnancies and deliveries of 17 patients with vasa praevia, who were observed in the clinic «Maternity Hospital №17» in 2014-2017. Results. In assessing the risk factors, low- lying placenta and marginal placenta prevalence occurred in 41,2%, multiple pregnancy in 29,4% and pregnancy as a result of IVF in 11,8% of patients. The average time of diagnosis of VP was 28 weeks 3 days. The average term of delivery was 35 weeks 2 days. All patients were delivered by cesarean section. There were 52,9% of elective surgeries and 47,1% of emergency surgeries. Intraoperative ultrasonography was used in 35,3% of cesarean sections. All newborns were delivered with an Apgar score more than 7/8; in the course of dynamic follow-up, nobody required blood transfusion in the postpartum period. The average weight of newborns was 2487,7 g. The average score on the Apgar scale was 7,8/8,8 points. 40,9% of newborns were required to transfer to the children’s hospital, all of whom were delivered by emergency indications and showed low weight at birth. 50% of newborns did not require being in the intensive care unit. Conclusion. The data obtained by us confirm the possibility of a significant reduction of perinatal morbidity and mortality of VP with a thorough ultrasound screening study, taking into account risk factors for development and adequate dynamic observation and timely delivery. Clinical Significance. The data obtained by us confirm the possibility of a significant reduction of perinatal morbidity and mortality with VP with a careful ultrasound screening study, taking into account the risk factors for this condition (low-lying placenta at early gestational age, velamentous cord insertion, IVF, multiple pregnancy) and adequate dynamic observation.