Vasa praevia: a lethal threat to the fetus

Vasa praevia constitutes a rare obstetric complication that is potentially lethal for the generally healthy infant. If unrecognized antenatally, the condition carries a higher fetal mortality rate than any other complication in pregnancy. Only in the past two decades have major diagnostic advances led to a dramatic improvement of perinatal survival and lower morbidity rates. Good outcomes depend primarily on prenatal diagnosis and appropriate management. The performance of a caesarean section before rupture of the membranes and the onset of labour is mandatory. Simple modifications of standard screening protocols and the recognition of high-risk patients will allow identification of most cases of vasa praevia.