VBAC, Vasa Previa and Pregnancy – Professional Choice

What Is Vasa Previa? Why VBAC? – Facts and Caveats

The umbilical cord, that precious link from Mother to unborn baby, seems to carry not only nutrients and oxygen-rich blood, but hopes and dreams. When that connection fails, dreams are dashed. With vasa previa, a rare condition where the vessels of the cord grow on its exterior, the results are usually fatal – unless a Cesarean section is performed.

What Is Vasa Previa?

In cases of vasa previa, the blood vessels run through the umbilical cord for some distance, then grow out of the cord and into the placenta. Without the tough fibrous cord, these fragile blood vessels have minimal support, with the only real support being the fetal membranes, or bag of waters.

The stress of labor and the bursting of the water sac often causes the vessels to tear. This results in the rapid death of the baby from blood loss. The mortality rate from undetected vasa previa is high, from 50 percent to 90 percent.

The heartbreak of vasa previa lies in the number of babies who perish due to a lack of diagnoses.

Little is known about what makes the vessels grow out of the cord. One reason may be that the nutrients in the bottom of the placenta are not as rich as the nutrients in the top of the placenta. The vessels may grow toward the better nutrition, just as a plant grows toward the sun.

Know the Risk Factors

  • Though no one knows exactly what causes vasa previa, there are some factors women should be aware of that place them at greater risk for developing the condition:
  • Women with low-lying placentas (near or over the cervix)
  • Multiple pregnancies
  • Pregnancies resulting from in vitro fertilization
  • Bi-lobed placentas (the placenta consists of more than the usual single piece)

And I knew from the moment I returned home, barely able to walk up my front steps, that this was not the way childbirth was meant to be.

Why VBAC?

Birth is a natural process. The overwhelming odds are that most women will have uncomplicated labors and deliveries. Yet, in these days of medical skill, Cesarean section is viewed as an equal alternative to vaginal birth. The truth is that Cesarean sections save lives, but statistics suggest many may be unnecessary.

In the United States, high Cesarean numbers cause the surgery to seem commonplace and make it easy to forget that this major abdominal surgery carries many risks.

In the United States, high Cesarean numbers cause the surgery to seem commonplace and make it easy to forget that this major abdominal surgery carries many risks. For Cindy Minear of Westminster, Calif., the decision to pursue a vaginal birth after a Cesarean was not difficult. She remembered all too well the seeping incision that needed to be re-opened and drained, and the nurses who came to her house twice a day to clean and repack the wound. “Not wanting to go through all the medical complications was the main factor in [deciding to have a VBAC],” Minear says.

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