Prenatal Diagnosis of Vasa Previa: Outpatient versus Inpatient Management

Abstract

Objective The aim of this study was to compare the pregnancy outcome of two different management strategies: outpatient versus inpatient in women with prenatal diagnosis of vasa previa.

Materials and Methods This is a retrospective cohort study conducted at a single tertiary center. Women with a prenatally diagnosed vasa previa between January 2007 and June 2017 were included. Obstetric and neonatal outcomes were compared between two management strategies: elective admission at 34 weeks of gestation or outpatient management unless there were signs of labor or premature contractions.

Results A total of 109 women met the inclusion criteria: 75 (68.8%) women in the inpatient group and 34 (31.2%) in the outpatient group. Women in the inpatient group were more likely to receive antenatal steroids (57.3 vs. 26.4%, p = 0.002) and were less likely to have an urgent cesarean section (34.6 vs. 58.8%, respectively, p < 0.001) compared with outpatient group. There was no difference in the rate of neonatal complications (inpatient: 64.6% vs. outpatient: 52.7%, p = 0.27) or neonatal anemia requiring transfusion (2.7 vs. 5.8%, respectively, p = 0.5) between the groups.

Conclusion The rate of elective cesarean section and exposure to antenatal steroids was higher in patients with vasa previa who were admitted electively at 34 weeks of gestation compared with patients who were managed as outpatient.

Keywords

vasa previa - prenatal diagnosis - management - elective cesarean section - late preterm

Note

This study was presented as a poster presentation at the Society of Maternal-Fetal Medicine 38th Annual Meeting, January 27 to February 3, 2018, Dallas, TX.

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