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Lead
Boston Children's Hospital
Age
18–55
Sex
FEMALE
Healthy volunteers
Not accepted
You may be eligible if
Pregnant patient
Singleton pregnancy
Confirmed diagnosis of vasa previa, defined as unprotected fetal vessels running through the membranes at or within 5cm of the internal cervical os. Diagnosis must be confirmed after 26w0d, and before 32w5d
Able to undergo intervention during 30w0d to 32w6d
Type II vasa previa in which one placental lobe is considered to be accessory, defined as constituting less than 20% of the total placental mass seen on MRI and US imaging
Type II vasa previa in which multiple bridging vessels connect the two placental lobes (≥4 vessels), and only 1-2 vessel(s) run through or within 5cm of the internal cervical os
Patient is eligible to undergo anesthesia
Patient and biological father of the fetus (if available) are able to provide signed informed consent
You may not be if
Gestational age at referral higher than 32w6d
Multiple pregnancy
Vasa previa types I and III
Type II vasa previa in which the accessory lobe constitutes more than 20% of the total placental mass, as determined by the fetal surgeon during diagnostic fetoscopy
Type II vasa previa in which all of the bridging vessels between placental lobes are running over the internal cervical os
Fetal growth restriction, defined as estimated fetal weight or abdominal circumference less than the 10th percentile for gestational age
Abnormal fetal brain MRI, including delayed maturation, hemorrhage, arterial ischemic injury, abnormal ventricular size, or any congenital anomalies
Allergy or previous adverse reaction to ancillary medications with no available alternative
Preterm contractions and PPROM before surgery
Preeclampsia or uterine anomaly during the current pregnancy
Suspicion of major recognized congenital syndrome on ultrasound or MRI that is not compatible with postnatal life
Maternal pre-pregnancy BMI \>40
Active hepatitis B, hepatitis C, or HIV infection
High risk for congenital fetal bleeding disorders
Unreliable pregnancy dating due to an irregular menstrual cycle/uncertain last menstrual period with no confirmed dating from first trimester ultrasound
The surgeon determines that the procedure is not feasible for any other reason after diagnostic fetoscopy
Clareo Health | Fetoscopic Laser Photocoagulation in Management of Vasa Previa
