“When I found out I was having twins, I was shocked. I remember crying and laughing at the doctor’s office, not yet sure how to feel about the huge news we had just been told. Now I know it was the biggest blessing we have ever received,” recalls Anna Havard as she reflects back on the precarious time leading up to the birth of her twins. During her pregnancy, one of her twins was diagnosed with vasa previa, a rare and life-threatening condition.
“Vasa previa occurs when the fetus’ umbilical vessels don’t come from the center of the placenta, but are traveling unprotected on the membranes, in close proximity to the birth canal. This puts them in a precarious position for spontaneous rupture. If these vessels were to rupture when the water breaks or labor starts, the fetus could suffer permanent brain injury or die in a matter of just a few minutes,” explains Nikolaos Zacharias, M.D., a maternal-fetal medicine (MFM) physician affiliated with Memorial Hermann Cypress Hospital and Assistant Professor of Obstetrics, Gynecology and Maternal-Fetal Medicine at McGovern Medical School at UTHealth.
Physicians do not recommend women with vasa previa deliver vaginally. Dr. Zacharias recommended Havard restrict her activity and deliver via pre-labor cesarean section by 34-35 weeks.
Doctor Prescribed Bed Rest for Weeks Leading Up to Delivery
“Being on bed rest was very challenging. I was on bed rest at home for a few weeks, and then at Memorial Hermann Cypress Hospital for about two weeks. My husband was still going to work, so it was nice that the hospital was close so that he could spend some time with me every day. Also, our family kept our daughter, Sophia, which helped ease the guilt of not being home for her,” says Havard. “Plus, the staff did their best to try and keep me comfortable and entertained. They were incredibly kind and accommodating throughout my stay.”
Finally, on July 17, Marina Claire and Elena Grace were delivered by C-section. They both would spend a few more weeks in the Neonatal Intensive Care Unit (NICU) before going home.
“By the time we took the girls home, I felt like I knew everyone there. You never want to spend an entire month in the hospital, but I felt like the staff really did care about me and wanted to make me as comfortable as possible,” says Havard.
Dr. Zacharias hopes Havard’s story will encourage other women to ask their doctors about seeing a high-risk pregnancy specialist.
Delivering Specialized Care for Moms-to-Be
“Our usual role is to act as a consultant for high-risk pregnancies to the general obstetrician and their patients. While a very experienced ultrasound technician might have spotted Anna’s condition, it is not the sort of thing you want to leave to chance. Undiagnosed cases of vasa previa have a bad outcome more than half the time, whereas prenatally diagnosed cases almost always do well,” adds Dr. Zacharias.
High-risk pregnancies include women with pre-existing health problems like diabetes, lupus, or high blood pressure, women pregnant with multiples, or women who have experienced pregnancy problems in the past, such as preterm birth or pre-eclampsia.
“ If you’re considered a high-risk pregnancy, you should schedule a consultation with a MFM,” recommends Dr. Zacharias. “Some women will see us once. Some women will see us through the duration of the pregnancy; it just depends on each individual case.”
“I am so thankful my OB/GYN recommended I see a MFM physician. Vasa previa is the type of condition they only check for if you’re a high-risk pregnancy. Even though I’m a healthy woman, having twins put me in the high-risk category and I’m so thankful that Dr. Zacharias and his team diagnosed the condition. If it had been missed, and I tried to deliver naturally, one of them might not have survived,” says Havard.