Fetoscopic Laser Surgery for Vasa Previa: Feasibility, Safety, and Future Directions.

Abstract

Vasa previa is an uncommon, potentially life-threatening condition where fetal vessels traverse the membranes over the cervix without Wharton jelly protection, risking fetal exsanguination if undiagnosed. Prenatal ultrasound and planned preterm cesarean reduce perinatal mortality to under 1%, though concerns about prematurity persist. Fetoscopic laser photocoagulation, initially used for twin-twin transfusion syndrome, shows promise in select cases, potentially allowing vaginal delivery at term. This review examines vasa previa management, the feasibility of laser therapy, and its risks. While early data are promising, further studies, including the FLUMEN trial, are needed to determine the safety and efficacy of this intervention.