Prenatal Diagnosis of Vasa Previa: Outpatient versus Inpatient Management

Michal Fishel Bartal; Baha M. Sibai; Hadas Ilan; Sharon Katz; Irit Schushan Eisen; Eran Kassif; Rakefet Yoeli; Yoav Yinon; Shali Mazaki-Tovi

doi:10.1055/s-0038-1669396

American Journal of Perinatology, Table of Contents

Am J Perinatol 2019; 36(04): 422-427
DOI: 10.1055/s-0038-1669396

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Prenatal Diagnosis of Vasa Previa: Outpatient versus Inpatient Management

Michal Fishel Bartal

¹Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

,

Baha M. Sibai

²Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UT Health), Houston, Texas

,

Hadas Ilan

¹Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

,

Sharon Katz

³Department of Neonatology, Sheba Medical Center, The Edmond and Lily Safra Children's Hospital, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

,

Irit Schushan Eisen

³Department of Neonatology, Sheba Medical Center, The Edmond and Lily Safra Children's Hospital, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

,

Eran Kassif

¹Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

,

Rakefet Yoeli

¹Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

,

Yoav Yinon

¹Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

,

Shali Mazaki-Tovi

¹Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

› Author Affiliations

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

Full Text

References

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