(656) Vasa Previa Management: Analysis of Maternal and Neonatal Outcomes Between Inpatient and Outpatient Approaches

There were 42 patients with singleton pregnancies that had a VP diagnosis. Of these, 22 were managed inpatient and 20 managed outpatient. The groups had a statistically significant difference in history of PTD (7 vs 1; p=0.0471). Average TVCL measurements at 20-24 weeks and 30-34 weeks between the inpatient (39.7 ± 5.7 and 39.2 ± 6.0 mm) and outpatient groups (41.2 ± 9.0 and 36.7 ± 6.6 mm) were not statistically different (p=0.56 and 0.27). However, inpatients were delivered earlier than outpatients (34.4 vs 35.0 weeks, p< 0.0001) and had significantly smaller infants (2.37 kg vs 2.82 kg, p=0.001). More neonatal complications occurred in the inpatient group compared to the outpatient group (64% vs 30%, p=0.029) and the length of stay in the neonatal intensive care unit (NICU) was greater in the inpatient than outpatient group (16 vs 3 days, p=0.0013). See Table 1.

Conclusion:

Our study found a higher risk of composite neonatal complications and a clinically significant difference in NICU length of stay in the inpatient group. A statistically significant difference in history of preterm delivery was noted between inpatient and outpatient managed VP patients which could have been an important factor in the incidence of complications noted in the inpatient group. Careful selection of candidates for outpatient management could be a favorable clinical approach based on this study's results.