دورية أكاديمية
أعرض في EDS

Perinatal Mortality Despite Prenatal Diagnosis of Vasa Previa: A Systematic Review.

التفاصيل البيبلوغرافية
العنوان: Perinatal Mortality Despite Prenatal Diagnosis of Vasa Previa: A Systematic Review.
المؤلفون: Heyborne K; Denver Health Medical Center and the University of Colorado School of Medicine, Aurora, Colorado.
المصدر: Obstetrics and gynecology [Obstet Gynecol] 2023 Sep 01; Vol. 142 (3), pp. 519-528.
نوع المنشور: Systematic Review; Journal Article
اللغة: English
بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 0401101 Publication Model: Print Cited Medium: Internet ISSN: 1873-233X (Electronic) Linking ISSN: 00297844 NLM ISO Abbreviation: Obstet Gynecol Subsets: MEDLINE
أسماء مطبوعة: Publication: 2004- : Hagerstown, MD : Lippincott Williams & Wilkins
Original Publication: New York.
مواضيع طبية MeSH: Vasa Previa*/diagnostic imaging , Vasa Previa*/epidemiology , Perinatal Death*, Infant, Newborn ; Pregnancy ; Female ; Humans ; Perinatal Mortality ; Retrospective Studies ; Prenatal Diagnosis ; Pregnancy, Twin ; Ultrasonography, Prenatal
مستخلص: Objective: To determine the causes and potential preventability of perinatal deaths in prenatally identified cases of vasa previa.
Data Sources: Reports of prenatally identified cases of vasa previa published in the English language literature since 2000 were identified in Medline and ClinicalTrials.gov with the search terms "vasa previa," "abnormal cord insertion," "velamentous cord," "marginal cord," "bilobed placenta," and "succenturiate lobe."
Methods of Study Selection: All cases from the above search with an antenatally diagnosed vasa previa present at delivery in singleton or twin gestations with perinatal mortality information were included.
Tabulation, Integration, and Results: Cases meeting inclusion criteria were manually abstracted, and multiple antenatal, intrapartum, and outcome variables were recorded. Deaths and cases requiring neonatal transfusion were analyzed in relation to plurality, routine hospitalization, and cervical length monitoring. A total of 1,109 prenatally diagnosed cases (1,000 singletons, 109 twins) were identified with a perinatal mortality rate attributable to vasa previa of 1.1% (95% CI 0.6-1.9%). All perinatal deaths occurred with unscheduled deliveries. The perinatal mortality rate in twin pregnancies was markedly higher than that in singleton pregnancies (9.2% vs 0.2%, P <.001), accounting for 80% of overall mortality despite encompassing only 9.8% of births. Compared with individuals with singleton pregnancies, those with twin pregnancies are more likely to undergo unscheduled delivery (56.4% vs 35.1%, P =.01) despite delivering 2 weeks earlier (33.2 weeks vs 35.1 weeks, P =.006). An institutional policy of routine hospitalization is associated with a reduced need for neonatal transfusion (0.9% vs 6.0%, P <.001) and a reduction in the perinatal mortality rate in twin pregnancies (0% vs 25%, P =.002) but not in singleton pregnancies (0% vs 0.5%, P =.31).
Conclusion: Routine hospitalization and earlier delivery of twins may result in a reduction in the perinatal mortality rate. A smaller benefit from routine admission of individuals with singleton pregnancies cannot be excluded. There is currently insufficient evidence to recommend the routine use of cervical length measurements to guide clinical management.
Competing Interests: Financial Disclosure The author did not report any potential conflicts of interest.
(Copyright © 2023 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.)
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تواريخ الأحداث: Date Created: 20230803 Date Completed: 20230821 Latest Revision: 20230914
رمز التحديث: 20230914
DOI: 10.1097/AOG.0000000000005296
PMID: 37535966
قاعدة البيانات: MEDLINE
الوصف
تدمد:1873-233X
DOI:10.1097/AOG.0000000000005296