Can vasa previa have a good outcome without a c-section? Is it possible for the membranes to rupture and not rupture the vessels? Is it still called vasa previa if you have large vessels running through the membranes that are unsupported by the placenta if they do not cross the cervix?
I have lots of questions because of something my midwife found after my last birth. She did not make it for the birth, but did arrive shortly after and did the standard follow up care. When she was examining the placenta she found something very unusual and called me and dh to have a look. She showed us some very large blood vessels (nearly as thick as a pencil) running through the membranes, not anywhere near or supported by the placenta. She mentioned that it was very rare and that we were VERY lucky they had not ruptured during delivery or we certainly would have lost the baby, and mostly probably me as well.
I wish I had taken photos, but at the time it wasn't important. As far as I recall there was no velamentous insertion or anything else unusual (such as a bi-lobed placenta etc). I did have a detailed 20 wk scan and no one said anything about placenta previa (which often leads to vasa previa). In fact, no one mentioned the location of the placenta at all, so I assumed it was normal.
In the weeks following that birth I did some research online and found the closest thing to what I had was called vasa previa. But it seems that it is ALWAYS associated with either an elective c-section (when known in advance) or a pretty poor outcome. I can't find anything about having something like this, and then having the membranes rupture without damaging these blood vessels. Does anyone know?
The information online is really scary, and dh and I spent several weeks feeling extremely blessed that things went well for us in our homebirth. It could have so easily gone the other way. In fact, one of the things that I keep thinking is that I am SO glad I did have a homebirth. My labor dragged on and off for three days, and during that time I was extremely opposed to ANY measures to speed things along. My midwife was (quite reasonably) concerned that I would get exhausted and not have the energy to deal with the hard labor when it came. But I had a really strong gut feeling that we should just let things happen. I cannot imagine having a hosp. birth in that situation and somehow escaping amniotomy. I even had thoughts during that last (third) day of labor when I wondered it breaking my water might not speed things along. But I didn't, and I am so glad I waited. I don't know for sure where the placenta was located, and where in my uterus these vessels were actually lying. But any artifical breaking of the water could have ruptured them. There are a lot of unknowns here, but I am guessing that by not interfering and allowing the membranes to rupture on their own (they did so at the very end, just a few minutes before the baby crowned) we allowed them to tear along the path of least resistance, not through those vessels.
Maybe I was just lucky, or maybe there was never any danger. I'll probably never know. But has anyone seen or experienced something like this before? It has been on my mind a lot lately, now that I am expecting again. I know that prior vasa previa is NOT a risk factor for recurrance. But I am so hoping to get a really knowledgeable US tech this time around, because I have a lot of questions about my placenta and any possible vasa previa.
Serena
I have lots of questions because of something my midwife found after my last birth. She did not make it for the birth, but did arrive shortly after and did the standard follow up care. When she was examining the placenta she found something very unusual and called me and dh to have a look. She showed us some very large blood vessels (nearly as thick as a pencil) running through the membranes, not anywhere near or supported by the placenta. She mentioned that it was very rare and that we were VERY lucky they had not ruptured during delivery or we certainly would have lost the baby, and mostly probably me as well.
I wish I had taken photos, but at the time it wasn't important. As far as I recall there was no velamentous insertion or anything else unusual (such as a bi-lobed placenta etc). I did have a detailed 20 wk scan and no one said anything about placenta previa (which often leads to vasa previa). In fact, no one mentioned the location of the placenta at all, so I assumed it was normal.
In the weeks following that birth I did some research online and found the closest thing to what I had was called vasa previa. But it seems that it is ALWAYS associated with either an elective c-section (when known in advance) or a pretty poor outcome. I can't find anything about having something like this, and then having the membranes rupture without damaging these blood vessels. Does anyone know?
The information online is really scary, and dh and I spent several weeks feeling extremely blessed that things went well for us in our homebirth. It could have so easily gone the other way. In fact, one of the things that I keep thinking is that I am SO glad I did have a homebirth. My labor dragged on and off for three days, and during that time I was extremely opposed to ANY measures to speed things along. My midwife was (quite reasonably) concerned that I would get exhausted and not have the energy to deal with the hard labor when it came. But I had a really strong gut feeling that we should just let things happen. I cannot imagine having a hosp. birth in that situation and somehow escaping amniotomy. I even had thoughts during that last (third) day of labor when I wondered it breaking my water might not speed things along. But I didn't, and I am so glad I waited. I don't know for sure where the placenta was located, and where in my uterus these vessels were actually lying. But any artifical breaking of the water could have ruptured them. There are a lot of unknowns here, but I am guessing that by not interfering and allowing the membranes to rupture on their own (they did so at the very end, just a few minutes before the baby crowned) we allowed them to tear along the path of least resistance, not through those vessels.
Maybe I was just lucky, or maybe there was never any danger. I'll probably never know. But has anyone seen or experienced something like this before? It has been on my mind a lot lately, now that I am expecting again. I know that prior vasa previa is NOT a risk factor for recurrance. But I am so hoping to get a really knowledgeable US tech this time around, because I have a lot of questions about my placenta and any possible vasa previa.
Serena
I was just making stuff up 
