Diagnosis and Management of Vasa Previa: A Comparison of 4 National Guidelines

Importance: Vasa previa represents an uncommon and life-threatening condition for the fetus. The prenatal identification of the condition may improve the outcome. Objective: The aim of this study was to synthesize and compare published evidence of 4 national guidelines on diagnosis and management of vasa previa. Evidence Acquisition: A descriptive review of 4 recently published national guidelines on vasa previa was conducted: Royal College of Obstetricians and Gynaecologists on Vasa Praevia: Diagnosis and Management, Society for Maternal-Fetal Medicine on Diagnosis and Management of Vasa Previa, Society of Obstetricians and Gynaecologists of Canada on Guidelines for the Management of Vasa Previa, and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists on Vasa Praevia. These guidelines were compared regarding recommendations on diagnosis and management, while the quality of evidence was also reviewed based on each method of reporting. Results: There were many similar recommendations in the compared guidelines regarding the diagnosis and management of vasa previa. Early prenatal diagnosis using ultrasound and color Doppler imaging, hospitalization or management as outpatients, and cesarean delivery in a tertiary center with experienced clinicians are the main recommendations. Conclusions: Evidence-based guidelines may increase the awareness of the diagnosis and management of vasa previa among health care professionals and lead to more favorable perinatal outcomes. Target Audience: Obstetricians and gynecologists, family physicians. Learning Objectives: After participating in this activity, the learner should be better able to identify possible risk factors associated with vasa previa in pregnant women; describe the best diagnostic methods in pregnant women with vasa previa; and propose the appropriate management in cases of vasa previa.