Incidence and Causes of Perinatal Death in Prenatally Diagnosed Vasa Previa: A systematic review and meta-analysis.

This systematic review and meta-analysis reviewed the literature on prenatally diagnosed vasa previa (VP) with the goal of establishing how often perinatal mortality occurs in pregnancies in which VP was diagnosed prenatally. All studies that reported prenatal diagnosis of VP were reviewed. We identified 113 studies that included 1297 pregnant individuals. This included 25 cohort studies with 1167 pregnancies and 88 case series or reports with 130 pregnancies. We excluded case reports and series from the meta analysis.
Overall, there were 13 perinatal deaths among these pregnancies, consisting of 2 stillbirths and 11 neonatal deaths. Only 6 of these deaths were attributable to VP. Among the cohort studies, the overall perinatal mortality was 0.94% (95% confidence interval, 0.52–1.70; I2=0.0%). The pooled perinatal mortality attributed to VP was 0.51% (95% confidence interval, 0.23–1.14; I2=0.0%). Stillbirth and neonatal death were reported in 0.20% (95% confidence interval, 0.05–0.80; I2=0.0%) and 0.77% (95% confidence interval, 0.40–1.48; I2=0.0%) of pregnancies, respectively.
Our study indicates that perinatal death following prenatal diagnosis of VP is uncommon, and over half of these deaths are not the result of VP. This will help reassure pregnant individuals who are diagnosed prenatally with VP, and will help guide counseling and management.