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Vasa previa: a multicenter retrospective cohort study.

Authors :
Erfani H
Haeri S
Shainker SA
Saad AF
Ruano R
Dunn TN
Rezaei A
Aalipour S
Nassr AA
Shamshirsaz AA
Vaughn M
Lindsley W
Spiel MH
Shazly SA
Ibirogba ER
Clark SL
Saade GR
Belfort MA
Shamshirsaz AA
Source :
American journal of obstetrics and gynecology [Am J Obstet Gynecol] 2019 Dec; Vol. 221 (6), pp. 644.e1-644.e5. Date of Electronic Publication: 2019 Jun 13.
Publication Year :
2019

Abstract

Objective: The objective of the study was to describe the characteristics and outcomes of patients with antenatal diagnosis of vasa previa and evaluate the predictive factors of resolution in a contemporary large, multicenter data set.<br />Study Design: This was a retrospective multicenter cohort study of all antenatally diagnosed cases of vasa previa, identified via ultrasound and electronic medical record, between January 2011 and July 2018 in 5 US centers. Records were abstracted to obtain variables at diagnosis, throughout pregnancy, and outcomes, including maternal and neonatal variables. Data were reported as median [range] or n (percentage). Descriptive statistics, receiver-operating characteristics, and logistic regression analysis were used as appropriate.<br />Results: One hundred thirty-six cases of vasa previa were identified in 5 centers during the study period, 19 (14%) of which resolved spontaneously at median estimated gestational age of 27 weeks [19-34]. All subjects with unresolved vasa previa underwent cesarean delivery at a median estimated gestational age of 34 weeks [27-39] with the median estimated blood loss of 800 mL [250-2000]. Rates for vaginal bleeding, preterm labor, premature rupture of membrane, and need for blood product transfusion were not different between the resolved and unresolved group (P = NS). The odds ratio for resolution in those with the estimated gestational age of less than 24 weeks at the time of diagnosis was 7.9 (95% confidence interval, 2.1-29.4) after adjustment for confounding variables.<br />Conclusion: Our data suggest that outcomes in antenatally diagnosed cases of vasa previa are excellent. Furthermore, our data report a higher chance of resolution when the condition is diagnosed before 24 weeks of gestation.<br /> (Copyright © 2019 Elsevier Inc. All rights reserved.)

Details

Language :
English
ISSN :
1097-6868
Volume :
221
Issue :
6
Database :
MEDLINE
Journal :
American journal of obstetrics and gynecology
Publication Type :
Academic Journal
Accession number :
31201807
Full Text :
https://doi.org/10.1016/j.ajog.2019.06.006