MRI prenatal diagnosis for vasa previa when inconclusive ultrasonography results come, cons and pros?
[Abstract] Objective To explore MRI assistance in diagnosing of vasa previa when ultrasonography is inconclusive.Design Apply MRI to identify vasa previa in cases that ultrasonography is inconclusive, and establish control group for comparison. Setting Vasa previa results in poor outcomes if not diagnosed prenatally, and ultrasonography usually can detect it, yet is inconclusive occasionally. Very few papers discussed advantages of MRI diagnosis on vasa previa. Sample From January 2018 to December 2021, 12 patients with suspected vasa previa but inconclusive ultrasonography diagnoses were enrolled into the study group. 51 patients diagnosed by ultrasonography as mild ventriculomegaly without vasa previa were enrolled into the control group. Methods Both groups took MRI scanning during the 3rd trimester to check the existence of vasa previa. Placentas from both groups were checked to confirm existences of vasa previa immediately at delivery, and postoperatively by pathology. Main Outcome Measures The vasa previa existences, types, positions and directions were checked in MRI. Results In the 12 patients from the study group, MRI demonstrated vasa previa in 11 patients. The rest one was excluded of vasa previa by MRI. In all the 51 patients from the control group, MRI had excluded vasa previa. Pathology examination after delivery had confirmed these MRI diagnoses.Conclusions When ultrasonography is inconclusive on vasa previa, MRI can offer some assistance in diagnosis. FundingMedical and Health Research Project of Zhejiang Province(2019ZH008).
[Key words] Vasa previa, Magnetic resonance imaging(MRI), Inconclusive ultrasonography, Parachute type of placenta, Mangrove placental vessels, Type Ⅲ vasa previa