Fetal death associated with vasa previa is said to be as high as 75 percent. Are the odds any better if diagnosis was made antepartum?
Most of the deaths described occur acutely after the bag of waters breaks and tears the vessel. Recognition of the problem can be delayed because of the normal “bloody show” that occurs as the cervix dilates. If this occurs at home then the likelihood of delivering baby in time to prevent death or injury becomes very unlikely. The other situation where problems for the baby occur is when the presenting part, usually the baby’s head drops so low into the pelvis that the vessel gets compressed, stopping blood flow. Again, whether this is a problem depends on how much blood is flowing through the vessel supplying the baby with oxygen. Knowing that the vessel is in a vulnerable position from both types of injury improves the likelihood of a good outcome. The biggest problem is trying to predict if and when such an event might occur. Hence the suggestion that you will spend some time in the hospital before baby is born.
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