A case of vasa previa diagnosed at the time of full opening of the uterine cervix

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  • YAMATO Natsuko
    Department of Obstetrics, Hyogo Prefectural Kobe Children’s Hospital Department of Obstetrics and Gynecology, Konan Medical Center
  • KUBOTA Shino
    Department of Obstetrics, Hyogo Prefectural Kobe Children’s Hospital
  • KANEKO Megumi
    Department of Obstetrics, Hyogo Prefectural Kobe Children’s Hospital
  • OGINO Michi
    Department of Obstetrics, Hyogo Prefectural Kobe Children’s Hospital
  • MATSUMOTO Masuyo
    Department of Obstetrics, Hyogo Prefectural Kobe Children’s Hospital
  • TAIRAKU Shinya
    Department of Obstetrics, Hyogo Prefectural Kobe Children’s Hospital
  • FUNAKOSHI Toru
    Department of Obstetrics, Hyogo Prefectural Kobe Children’s Hospital

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  • 分娩進行中に前置血管が顕在化した1例
  • ブンベン シンコウ チュウ ニ ゼンチ ケッカン ガ ケンザイカ シタ 1レイ

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Abstract

<p>Vasa previa is a rare but clinically important obstetrical complication that occurs in 2-6 of 10,000 pregnancies. Approximately 93% of cases are diagnosed in the second trimester, and a late preterm cesarean section increases the neonatal survival rate. We report a case of vasa previa diagnosed in the second stage of labor and refer to five previous cases. A 35-year-old female was referred to our hospital at 34 weeks of gestation for further examination of her fetal heart malformation. Fetal echocardiography showed tricuspid atresia (Ic). Transvaginal ultrasound (TVUS) showed no vasa previa or placenta previa. Induction of labor was performed at 39 weeks of gestation because she and her family live far away from the hospital. No vasa previa was found on TVUS at admission. The delivery progressed, and a cord-like object was palpated by pelvic examination at the time of full opening of the uterine cervix. We diagnosed vasa previa by TVUS and performed an emergency cesarean section. A healthy 2904g female infant was successfully delivered, with an Apgar score of 6/9. There was no blood loss during delivery. Evaluation of the placenta confirmed the diagnosis of vasa previa. We could know that we should examine carefully when the delivery progressed especially we couldn’t determine insertion of the umbilical cord clearly. [Adv Obstet Gynecol, 75(1) : 45-50, 2023(R5.2)]</p>

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