Vasa previa (VP) is currently managed by antepartum hospital admission at 28–32 weeks’ gestation followed by planned cesarean delivery at 34–37 weeks. Fetoscopic laser ablation (FLA) has been proposed as an alternative strategy for Types II and III VP. This study compared FLA with standard management for maternal and neonatal outcomes in 67 singleton pregnancies with Type II or III VP. In the FLA group, the median gestational age at delivery was 36.0 weeks compared with 34.4 weeks in the standard management group.
Vaginal delivery occurred in 62.9% of the FLA group. Maternal antepartum hospital stay was markedly shorter with FLA (median 1 day vs 16 days). Notably, neonatal blood transfusion was required in none of the FLA cases compared with 18.8% in the standard management group. These findings suggest that third-trimester FLA may allow later delivery and facilitate vaginal birth in…
