Vasa previa: a multicenter retrospective cohort study.
Am J Obstet Gynecol
; 221(6): 644.e1-644.e5, 2019 12.
Article
em En
| MEDLINE
| ID: mdl-31201807
ABSTRACT
OBJECTIVE:
The objective of the study was to describe the characteristics and outcomes of patients with antenatal diagnosis of vasa previa and evaluate the predictive factors of resolution in a contemporary large, multicenter data set. STUDYDESIGN:
This was a retrospective multicenter cohort study of all antenatally diagnosed cases of vasa previa, identified via ultrasound and electronic medical record, between January 2011 and July 2018 in 5 US centers. Records were abstracted to obtain variables at diagnosis, throughout pregnancy, and outcomes, including maternal and neonatal variables. Data were reported as median [range] or n (percentage). Descriptive statistics, receiver-operating characteristics, and logistic regression analysis were used as appropriate.RESULTS:
One hundred thirty-six cases of vasa previa were identified in 5 centers during the study period, 19 (14%) of which resolved spontaneously at median estimated gestational age of 27 weeks [19-34]. All subjects with unresolved vasa previa underwent cesarean delivery at a median estimated gestational age of 34 weeks [27-39] with the median estimated blood loss of 800 mL [250-2000]. Rates for vaginal bleeding, preterm labor, premature rupture of membrane, and need for blood product transfusion were not different between the resolved and unresolved group (P = NS). The odds ratio for resolution in those with the estimated gestational age of less than 24 weeks at the time of diagnosis was 7.9 (95% confidence interval, 2.1-29.4) after adjustment for confounding variables.CONCLUSION:
Our data suggest that outcomes in antenatally diagnosed cases of vasa previa are excellent. Furthermore, our data report a higher chance of resolution when the condition is diagnosed before 24 weeks of gestation.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Remissão Espontânea
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Hemorragia Uterina
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Ruptura Prematura de Membranas Fetais
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Cesárea
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Transfusão de Componentes Sanguíneos
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Vasa Previa
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Trabalho de Parto Prematuro
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
/
Incidence_studies
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Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adolescent
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Adult
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Female
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Humans
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Pregnancy
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article