In utero laser treatment of type II vasa previa

Abstract

Vasa previa, defined as fetal vessels coursing within the membranes between the presenting part and the cervix, occurs in approximately 1:2500–5000 pregnancies. Type II vasa previa consists of fetal vessels crossing over the internal os connecting a bilobed placenta or a succenturiate lobe with the main placental mass. These vessels are prone to compression during labor or may tear when membranes rupture potentially resulting in fetal exsanguination and neonatal death. This complication could be avoided altogether if the vessels could be obliterated in utero. The purpose of this communication is to report the successful in utero laser ablation of type II vasa previa at 22.5 weeks of gestation. Subsequent ruptured membranes did not result in untoward fetal consequences. Risks and benefits of this novel procedure are discussed.

Keywords:

• Vasa previa
• operative fetoscopy
• ultrasound
• Doppler
• fetal therapy