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BFP after IVF? Twins? Be aware of vasa previa

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VasaPrevia Sat 23-Feb-19 08:40:29

Vasa previa is a very rare condition leading to stillbirth that is much more common in IVF and twin pregnancies; it is different from placenta previa. I had it during my IVF pregnancy and so experienced firsthand how easily it can be overlooked, so if wanted to pass on information to the ladies on this board as you may have to advocate for yourself. (Luckily, and it was only down to luck, my baby survived.)

If you have a non-IVF pregnancy, your odds of vasa previa are 0.006 in 100. After IVF, your chance of having it may be as high as 0.5 or 1 in 100 (estimates vary). This is still infrequent, but much more common than many other conditions screened for in pregnancy; nevertheless it is not checked for even if you had IVF.

In vasa previa, a blood vessel belonging to the foetus crosses the cervix and is unprotected. When labour starts, the vessel ruptures and the healthy baby bleeds to death in a matter of minutes. The vessel can also be ruptured by normal pelvic exams in pregnancy so it is important to know about the condition as early as possible.

Vasa previa can be completely symptom free during pregnancy, It can’t be clearly seen on a normal ultrasound. Owing to its rareness in non-IVF pregnancies, many medical professionals won’t have seen it in a patient and it won’t be at the forefront of their minds. They might not be aware of the increased frequency in IVF pregnancies. Nine different doctors missed mine.

What can you do as a patient?
* You may need to remind people that this is an IVF pregnancy. I usually found that this wasn’t noticed from my notes.
* Ask at scans where your placenta is. If it is low-lying or in two parts at 20 weeks, ask for a vaginal doppler scan to rule out vasa previa.
* If you have placenta previa at 20 weeks that corrects itself by e.g. 28 weeks, ask about vasa previa as it is thought to occur when the placenta moves up but a vesel is left behind. Ask even if you were checked at 20 weeks.
* If you have placenta previa and will be having a section, ask to be checked for vasa previa too.
* If you have bleeding without pain in the second trimester, ask whether the blood could be foetal blood (it can be tested) and ask about vasa previa.

If you are found to have it, ask to see a specialist and be concerned if you are told that you could try to labour naturally. Also be concerned if you are told that the vessel has ‘moved up’ as this is condition rare and may be a sign of misdiagnosis.

Treatment is very simple: a section by 36 weeks, with a 95% chance of the baby surviving (compared with a 5% chance when undiagnosed).

I am sorry to give you yet another thing to worry about, and it is still very unlikely that you will get this, but I think it is something we need to be aware of. Personally I think the clinics should warn you at the viability scan when they discharge you to normal maternity services, but as they don’t, I think it’s good to know.

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