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Vasa previa occurs in about 1 in every 2,000 to 5,000 pregnancies. Despite advances in medical technology, the condition often goes undetected until it is too late and then an emergency caesarian section and aggressive resuscitation is required to save the baby. Vasa previa has a high death rate if its not caught before labor, because many babies lose most or all of their blood supply within a few minutes when their mothers water breaks. A color Doppler ultrasound showing blood flow in the womb can help detect vasa previa, but unless a woman is identified as having a high-risk pregnancy, she typically does not get this more sophisticated test during pregnancy.

The 37-year-old patient described in the published report had an abnormal placenta with one smaller and one larger lobe linked by two exposed fetal vessels. Normally the blood vessels feeding the fetus are embedded in the placenta or umbilical cord, but in this case the vessels linked the two lobes. This would not necessarily be life-threatening if the unsupported vessels were positioned in other areas of the uterus but these vessels were caught between the fetus and the opening to the birth canal (cervix). Such exposed vessels are prone to tearing when the patients amniotic membranes rupture, or they may be compressed between the baby and the walls of the birth canal during birth, cutting off oxygen to the baby.

There is no uniform standard of care for vasa previa. When the condition is diagnosed, physicians often manage it by recommending bed rest, hospitalizing the patient beginning at 7 months of pregnancy and scheduling an elective cesarean delivery before labor. However, Dr. Quintero suggests, the risk of fetal death might be substantially minimized if the unpr
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