Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University; Chengdu, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China.
Biosci Trends. 2021 May 11;15(2):118-125. doi: 10.5582/bst.2021.01052. Epub 2021 Mar 21.
Vasa previa (VP) is a rare and life-threatening condition for the fetus. It is associated with increased perinatal mortality rates. The current study sought to retrospectively analyze the perinatal outcomes of VP in singleton and multiple pregnancies between January 1, 2013 and December 31, 2019 at a tertiary hospital in west China. One hundred and fifty-seven cases of VP were identified, including 131 singletons, 23 twins and 3 triplets. VP in 20 cases was diagnosed at delivery. There were 183 live births. Neonatal mortality was significantly higher in cases with no prenatal diagnosis (9.7% vs. 1.3%, p = 0.035). There was a significantly higher rate of NICU admission, premature infant and neonatal pneumonia in cases with prenatal diagnosis (p < 0.05). Among twin pregnancies with VP as a prenatal diagnosis, there were significantly earlier gestational age at admission (31.1 vs. 34.1 weeks, p = 0.000) and delivery age (33.4 vs. 35.3 weeks, p = 0.000) than those among singleton pregnancies. The neonatal mortality in twins with prenatal diagnosis was significantly higher than that in singletons (0% vs. 6.9%, p = 0.037). Early hospitalization of VP in the third trimester may be reasonable. The data suggest that the timing of elective delivery at 34-36 weeks in singletons and 32-34 weeks in twins may be suitable. It should be emphasized to make corresponding optimal delivery time according to individual differences for the women, especially in twin pregnancy.
帆状胎盘前置（VP）是一种罕见的、危及胎儿生命的疾病，与围产儿死亡率增加有关。本研究旨在回顾性分析 2013 年 1 月 1 日至 2019 年 12 月 31 日在中国西部一家三级医院中单胎和多胎妊娠中 VP 的围产结局。共确定 157 例 VP 病例，其中单胎 131 例，双胎 23 例，三胎 3 例。20 例 VP 在分娩时诊断。共有 183 例活产。无产前诊断的病例新生儿死亡率明显较高（9.7% vs. 1.3%，p = 0.035）。有产前诊断的病例中，NICU 入院率、早产儿和新生儿肺炎的发生率明显较高（p < 0.05）。在 VP 作为产前诊断的双胎妊娠中，入院时的胎龄（31.1 周 vs. 34.1 周，p = 0.000）和分娩年龄（33.4 周 vs. 35.3 周，p = 0.000）明显早于单胎妊娠。有产前诊断的双胎妊娠的新生儿死亡率明显高于单胎妊娠（0% vs. 6.9%，p = 0.037）。在孕晚期对 VP 进行早期住院治疗可能是合理的。数据表明，对单胎妊娠在 34-36 周、双胎妊娠在 32-34 周进行选择性分娩的时机可能是合适的。应强调根据个体差异为孕妇制定相应的最佳分娩时间，尤其是在双胎妊娠中。
