Understanding Suspected Vasa Praevia: What It Means For Your Pregnancy

Pregnancy is a time of excitement, but it can also be filled with uncertainties. As you progress through your antenatal care, you may hear various medical terms, some of which may cause concern or confusion. One such term is “suspected vasa praevia.” But what does this mean for your pregnancy? In this article, we will explore what vasa praevia is, how it is diagnosed, the potential risks it poses to both the mother and baby, and how it is managed during pregnancy. We will also provide practical advice on how to navigate antenatal care if you have been diagnosed with suspected vasa praevia, and what steps to take to ensure the health of both you and your baby.

What is Vasa Praevia?

Vasa praevia is a rare but serious pregnancy complication in which fetal blood vessels cross or run near the opening of the cervix. These vessels are part of the umbilical cord or placenta and can be at risk of rupture when the cervix dilates during labour. This can lead to heavy bleeding and potentially threaten the life of the baby. Vasa praevia can be suspected during routine antenatal scans, and its identification is crucial for ensuring the safety of both the mother and baby. This condition is different from other more common pregnancy complications, such as placenta praevia, in that it involves the blood vessels rather than the placenta itself.

The Role of Antenatal Scans in Detecting Vasa Praevia

Antenatal scans are an essential part of pregnancy care, allowing healthcare professionals to monitor the development of the baby and identify any potential complications. The 20-week anomaly scan is a key time when vasa praevia may be detected. During this scan, doctors or sonographers may observe the location of the blood vessels in relation to the cervix. If the blood vessels are found to be crossing the cervix or too close to it, they may diagnose a suspected case of vasa praevia. If vasa praevia is suspected, your doctor will likely recommend further scans, such as a transvaginal ultrasound, to get a clearer picture of the blood vessel placement. These scans can help your healthcare provider determine the best course of action for managing the pregnancy.

Causes and Risk Factors of Vasa Praevia

The exact cause of vasa praevia is not always clear, but there are several factors that may increase the risk of developing this condition:

• Placenta Previa: If the placenta is positioned low in the uterus, it can increase the risk of vasa praevia. This is because the blood vessels may lie near or over the cervix.
• Multiple Pregnancies: Women carrying twins, triplets, or more may have an increased risk of vasa praevia, as the placental structure can be more complex in multiple pregnancies.
• Placental Abnormalities: Some abnormalities in placental implantation can result in abnormal blood vessel placement, leading to vasa praevia.
• Previous Cesarean Section: A history of cesarean section may also increase the likelihood of developing vasa praevia, particularly if there are scar tissues or adhesions in the uterus that affect the positioning of the placenta or vessels. While these factors increase the risk, vasa praevia can occur without any of them, so it is important for all expectant mothers to receive regular antenatal scans to monitor the position of the placenta and blood vessels.

Potential Risks of Vasa Praevia

The main concern with vasa praevia is the risk of vessel rupture, which can cause severe bleeding. If the blood vessels rupture during labour, it can lead to life-threatening complications for the baby, including hypovolemic shock, which occurs when the body loses too much blood. This is why vasa praevia is considered a medical emergency and requires careful management during pregnancy and delivery. For the mother, the risks are less direct, but there may be an increased likelihood of requiring a cesarean section if the blood vessels are at risk of rupture. There can also be emotional stress and anxiety as a result of the diagnosis, which can impact overall well-being.

How Vasa Praevia is Managed During Pregnancy

If you are diagnosed with suspected vasa praevia, your antenatal care team will monitor your pregnancy closely to ensure both you and your baby remain safe. The following strategies may be part of your pregnancy care plan:

1. Frequent Antenatal Appointments and Scans

Your doctor will likely recommend more frequent antenatal appointments and ultrasounds to track the positioning of the blood vessels and monitor the baby’s growth and well-being. These scans may help determine whether the vessels move or change positions as your pregnancy progresses.

2. Plan for Early Delivery

In many cases, a cesarean section will be scheduled before labour begins. This is because the risk of vessel rupture increases during labour and delivery. A planned cesarean section is typically done between 34-37 weeks, depending on the baby’s development and overall health. Early delivery can help avoid the complications associated with labour and delivery in cases of vasa praevia.

3. Hospitalisation and Bed Rest

In some cases, if there is concern about preterm labour or early rupture of the blood vessels, your doctor may recommend hospitalisation or restricted activity. Bed rest can help reduce the risk of premature rupture of membranes (the breaking of the waters) and manage the pressure on the cervix. This approach is used on a case-by-case basis, depending on the severity of the condition.

4. Antenatal Education and Support

If you are diagnosed with vasa praevia, antenatal education is essential. Attending antenatal classes can provide information on the potential risks and the planned course of action for delivery. You may also be offered emotional support to cope with any anxiety you may feel. Pregnancy care providers often offer psychological support to help you manage the stress of a complicated pregnancy.

5. Blood Transfusions (If Necessary)

In some cases, if bleeding occurs during the pregnancy, a blood transfusion may be required to manage the blood loss. This would typically be managed in a hospital setting with a well-established team of healthcare professionals.

Labour and Delivery Considerations

When it comes to the delivery of a baby with vasa praevia, careful planning is necessary. Most women with vasa praevia will require a cesarean section to ensure a safe birth. Labour can cause the blood vessels to rupture, which may be life-threatening for both mother and baby, so the emphasis is on preventing such an event. Cesarean delivery is typically scheduled for 34-37 weeks of gestation to reduce the risk of complications. Some women may also have to undergo immediate delivery if signs of premature rupture of membranes, heavy bleeding, or fetal distress occur.

What You Can Do to Support Your Pregnancy

In addition to working closely with your antenatal care team, there are a few things you can do to ensure your pregnancy remains as healthy as possible:

• Follow all medical recommendations: Attend all antenatal appointments, follow the advice of your healthcare provider, and keep them informed about any changes in your health or symptoms.
• Manage stress: Pregnancy can be a stressful time, and being diagnosed with a complicated condition like vasa praevia can add to the anxiety. Take time to relax, practice mindfulness, and engage in gentle activities like antenatal yoga or prenatal massage to help with relaxation and stress reduction.
• Prioritise self-care: Make sure to rest when needed and avoid activities that may put undue strain on your body. Eating a balanced diet, staying hydrated, and taking your antenatal vitamins will support both you and your baby’s health.
• Consider professional support: If you’re feeling anxious or overwhelmed, seeking emotional support or counselling can be beneficial. Pregnancy can be a challenging time, and having someone to talk to can make a significant difference. Being diagnosed with a suspected case of vasa praevia can understandably cause concern, but with careful antenatal care and planning, the risks to both you and your baby can be minimised. Regular scans, close monitoring, and a planned cesarean delivery are key components in managing this rare condition. By following the guidance of your healthcare provider and taking steps to manage stress and care for your physical and emotional well-being, you can navigate this challenging time with confidence. As always, it’s important to stay informed about your pregnancy and seek help when needed. With proper antenatal care, the outlook for both you and your baby can be positive, and you can focus on the joys of bringing a new life into the world.