Term vaginal delivery following fetoscopic laser photocoagulation of type II vasa previa.
Unrecognized vasa previa carries a significant risk of fetal mortality. Advances in ultrasound have improved detection of vasa previa and led to a dramatic reduction in fetal morbidity and mortality. However, current management strategies require prolonged hospitalized surveillance, preterm delivery prior to the onset of labor or rupture of membranes, and a cesarean delivery. Fetoscopic laser ablation of type II vasa previa allows for the possibility of term vaginal delivery. We present a patient who underwent successful laser photocoagulation of a type II vasa previa at 32(5)/7 weeks' gestation. She subsequently delivered vaginally at term without complications. The potential benefits of definitive in utero treatment of non-type I vasa previa, such as vaginal delivery at term, must be weighed against the procedure-related risks of operative fetoscopy.
Department of Obstetrics and Gynecology, UC Irvine Medical Center, Orange, Calif., USA.
R
R
Johnston
V K
VK
Shrivastava
R H
RH
Chmait
D000328:Adult; D036861:Delivery, Obstetric; D005260:Female; D005332:Fetoscopy; D006801:Humans; D011247:Pregnancy; D047929:Term Birth; D016896:Treatment Outcome; D055949:Vasa Previa / Q000601:surgery*