Vasa Previa
Description
- Vasa previa is a rare developmental disorder made up of two separate disorders.
- 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.
- 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
- Vasa previa is of no danger to the mother.
- Once the umbilical vessels rupture, fetal demise is virtually certain.
2. Clinical manifestations
- Vessels are occasionally palpated during a vaginal examination.
- Minimal bright red vaginal bleeding is evident.
- Fetal bradycardia occurs.
3. Laboratory and diagnostic study findings
- Ultrasound may reveal vasa previa.
- 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.
- Monitor fetal heart rate and status during labor.
- Assist with diagnosis of the condition.
- 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.