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Published byHeather Skinner Modified over 9 years ago
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Clinical Presentations, Outcomes and Implications
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Evaluate patients with diagnosis of vasa previa and assess outcomes in order to develop recommendations
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32yo G3P2002 with Di-Di twins and h/o 2 prior c/s Twin A initially noted to have velamentous CI, no vasa previa at 20wga Presented with VB at 25w5d. Developed/Identified as placenta previa with velamentous CI and vasa previa at 25w6 d/c’ed, returned with 2 nd bleed at 26w3d, signed out AMA HD#8 Presented in labor at 32w2d, 2-3cm visually dilated with bulging membranes
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Pathologic Diagnosis : A. Twin placenta: -Third trimester dichorionic diamniotic twin placenta: -Twin #1 placenta showing intervillous hemorrhage, acute chorioamnionitis and velamentous insertion of cord. -Twin #2 placenta showing velamentous insertion of cord.
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20w US : complete previa with marginal cord insertion Progressed to marginal placenta previa with velamentous cord insertion and vasa previa Plan to admit at 32wga (tomorrow) Plan for delivery at 34wga
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33yo G1P0 with anterior placenta, posterior succenturate lobe, marginal placenta previa, vasa previa. Admitted at 32wga for surveillance Plan for delivery between 34 and 35 wga
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41yo G1P0 with vasa previa, low lying placenta, marginal, possible velamentous C Admit at 32w2d Scheduled delivery at 34 WGA
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