The usefulness of MRI for vasa previa: Considered from two cases observed at our hospital

Abstract

 Vasa previa is recognized as a perinatal high risk pregnancy resulting in fetal death due to rupture of umbilical cord vessels. The accurate location of the cord vessels is important in perinatal management. However, evaluation of vasa previa with ultrasonography may be inconclusive for accuracy of the vessel location and running vessels. In this case study, we report two patients in whom accurate evaluation using magnetic resonance imaging（MRI）was useful.

 Case 1 was a 30-year-old pregnant woman, para 1. Vasa previa was diagnosed on transvaginal ultrasonography at 30 weeks, but assessment of the distance from the internal cervical os was difficult. However, the distance from the internal cervical os to the vasa previa was accurately evaluated on MRI, allowing careful planning of Cesarean section, allowing safe perinatal care. Case 2 was a 26-year-old pregnant woman, para 3. Vasa previa was diagnosed on transvaginal ultrasonography at 26 weeks. The patient underwent MRI for vessel course evaluation, which revealed five fetal vessels, including the vasa previa, crossing over the anterior wall of the uterus in a complex manner. Consequently, Cesarean section was performed safely, without damaging the vessels.

 These cases indicate that MRI for vasa previa can facilitate the evaluation of the accurate location and vessel course, leading to safe perinatal care.