A vasa previa is associated with very high fetal mortality rates and is often not detected until catastrophic events occur. As was the case discussed in this report, a vasa previa is often associated with a velamentous insertion of the umbilical cord. In most cases, an abnormal insertion of the umbilical cord is not made until the placenta and the amniotic membranes are examined following delivery. Utilizing both gray-scale and color Doppler sonography, it is possible to diagnose both these conditions prenatally in order to provide clinical information pertinent to subsequent fetal outcome.
Eddleman KA , Lockwood CJ, Berkowitz GS, Lapinski RH, Berkowitz RL: Clinical significance and sonographic diagnosis of velamentous umbilical cord insertion. Am J Perinatol1992;9:123–126.
2.
Benirschke K , Kaufmann P:Pathology of the Human Placenta. 3rd ed.New York: Springer-Verlag, 1995, pp 340–342.
3.
Herrera E , Pernoll ML: Complications of labor and delivery, in Pernoll ML (ed), Current Obstetric and Gynecologic Diagnosis and Treatment. 7th ed.Norwalk, CT: Appleton and Lange, 1991, p 493-493.
4.
Robinson LK , Jones KL, Benirschke K: The nature of structural defects associated with velamentous and marginal insertion of the umbilical cord. Am J Obstst Gynecol1983; 146:191–193.
5.
Bjoro K : Vascular anomalies of the umbilical cord II: perinatal and pediatric implications. Early Hum Dev1983;8: 279–287.
6.
Timor-Tritsch IE , Monteagudo A:Ultrasound and Multifetal Pregnancy. New York: Pathenon, 1998, pp 15–26.
7.
Fries M , Goldstein R, Kilpatrick S, Golbus MS, Callen PW, Filly RA: The role of velamentous cord insertion in the etiology of twin-twin transfusion syndrome. Obstet Gynecol1993;81:569–574.
8.
Kouyoumdjian A : Velamentous insertion of the umbilical cord. Obstet Gynecol1980;56:737–740.
9.
Oyelese KO , Schwarzler P, Coates S, Sanusi FA, Hamid R, Campbell S: A strategy for reducing the mortality rate from vasa previa using transvaginal sonography with color Doppler. Ultrasound Obstet Gynecol1998;12:434–438.
10.
Nomiyama M , Toyota Y, Kawano H: Antenatal diagnosis of velamentous umbilical cord insertion and vasa previa with color Doppler imaging. Ultrasound Obstet Gynecol1998; 12:426–429.
