Vasa Previa

Description
  • Vasa previa is a rare developmental disorder made up of two separate disorders.
  1. First, there is a velamentous insertion of the umbilical cord. This is a condition where the umbilical blood vessels course through the amnion and chorion and meet to form the umbilical cord a distance from the placental surface. This places the fragile umbilical vessels at risk for tearing and hemorrhage.
  2. A vasa previa is created when the fragile unprotected umbilical vessels cross the internal os and are in front of the presenting fetal head.

 

Etiology
  • The etiology is uncertain. However, it may be due to uneven growth of the placenta or abnormal implantation of the blastocyte.
Pathophysiology
  • The fetal vessels rupture or are compressed, leading to fetal hypoxia.
Assessment Findings

1. Associated findings

  1. Vasa previa is of no danger to the mother.
  2. Once the umbilical vessels rupture, fetal demise is virtually certain.

2. Clinical manifestations

  1. Vessels are occasionally palpated during a vaginal examination.
  2. Minimal bright red vaginal bleeding is evident.
  3. Fetal bradycardia occurs.

3. Laboratory and diagnostic study findings

  1. Ultrasound may reveal vasa previa.
  2. Kleihauer-Betke or fetal cell blood test will confirm the presence of fetal blood cells.
Nursing Management

1. Identify, and assist with treatment of, the disorder.

  1. Monitor fetal heart rate and status during labor.
  2. Assist with diagnosis of the condition.
  3. Anticipate and assist with emergency cesarean birth.

2. Provide physical and emotional support.

3. Provide client and family education. Explain emergency procedures to the client and family.

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