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Vasa Previa !

Vasa Previa !. Clinical Presentations, Outcomes and Implications. Purpose . Evaluate patients with diagnosis of vasa previa and assess outcomes in order to develop recommendations. Increased risk of Vasa previa. K.B. 32yo G3P2002 with Di-Di twins and h/o 2 prior c/s

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Vasa Previa !

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  1. VasaPrevia! Clinical Presentations, Outcomes and Implications

  2. Purpose • Evaluate patients with diagnosis of vasaprevia and assess outcomes in order to develop recommendations

  3. Increased risk of Vasaprevia

  4. K.B. • 32yo G3P2002 with Di-Di twins and h/o 2 prior c/s • Twin A initially noted to have velamentous CI, no vasapreviaat 20wga • Presented with VB at 25w5d. • Developed/Identified as placenta previa with velamentous CI and vasaprevia at 25w6 • d/c’ed, returned with 2nd bleed at 26w3d, signed out AMA HD#8 • Presented in labor at 32w2d, 2-3cm visually dilated with bulging membranes

  5. Pathologic Diagnosis : A. Twin placenta: -Third trimester dichorionicdiamniotic twin placenta: -Twin #1 placenta showing intervillous hemorrhage, acute chorioamnionitis and velamentous insertion of cord. -Twin #2 placenta showing velamentous insertion of cord.

  6. J.B.: • 20w US : complete previa with marginal cord insertion • Progressed to marginal placenta previa with velamentous cord insertion and vasaprevia • Plan to admit at 32wga (tomorrow) • Plan for delivery at 34wga

  7. JB: marginal placenta, velamentous cord insertion

  8. K.S. • 33yo G1P0 with anterior placenta, posterior succenturate lobe, marginal placenta previa, vasaprevia. • Admitted at 32wga for surveillance • Plan for delivery between 34 and 35 wga

  9. K.D. • 41yo G1P0 with vasaprevia, low lying placenta, marginal, possible velamentous C • Admit at 32w2d • Scheduled delivery at 34 WGA

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