{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T08:10:08Z","timestamp":1781165408713,"version":"3.54.1"},"reference-count":50,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,1,2]],"date-time":"2024-01-02T00:00:00Z","timestamp":1704153600000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Type\u2010III vasa previa (VP) is a rare form of VP, not necessarily associated with other placental or vascular anomalies, in which aberrant vessels run from the placenta to the amniotic membranes, near the internal cervical os, before returning to the placenta. Early diagnosis of Type\u2010III VP is important but technically challenging. The objective of this study was to gather the current available evidence on the perinatal diagnosis and outcome of Type\u2010III VP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic review of the literature on the perinatal diagnosis of atypical Type\u2010III VP was carried out in PubMed, MEDLINE and EMBASE accordingto PRISMA guidelines from inception to March 2023. Data extraction and tabulation were performed by two operators and checked by a third senior author. The quality of the included studies was evaluated using the National Institutes of Health tool for the quality assessment of case\u2010series studies. Our local ultrasound database was searched for previously unreported recent  cases. Characteristics of prenatally and postnatally diagnosed Type\u2010III VP, including clinical features and perinatal outcomes, were summarized using descriptive statistics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighteen cases of Type\u2010III VP were included, of which 16 were diagnosed prenatally (14 cases were retrieved from 10 publications and two were unpublished cases from our center) and two were diagnosed postnatally (retrieved from two publications). All prenatal cases were diagnosed on transvaginal ultrasound at a mean gestational age of 29\u2009weeks (median, 31\u2009weeks; range, 19\u201338\u2009weeks). Conception was achieved with <jats:italic>in\u2010vitro<\/jats:italic> fertilization in 4\/16 (25.0%) cases. There were no prenatal symptoms in 15\/18 (83.3%) cases, while in two (11.1%) cases there was vaginal bleeding and in one (5.6%) preterm labor occurred. In 15\/18 (83.3%) cases, at least one placental abnormality was observed, including low\u2010lying insertion (9\/17), succenturiate or accessory lobe (1\/17), velamentous cord insertion (3\/18) and marginal insertion (9\/18). All prenatally diagnosed cases were liveborn and were delivered by Cesarean section before rupture of membranes at a median gestational age of 35\u2009weeks (range, 32\u201338\u2009weeks) without neonatal complications. Emergency Cesarean section was performed in 2\/16 (12.5%) cases with a prenatal diagnosis and 1\/2 (50.0%) cases with a postnatal diagnosis (<jats:italic>P<\/jats:italic>\u2009=\u20090.179). Among those with data available, an Apgar score of \u2264\u20097 was observed in the prenatally <jats:italic>vs<\/jats:italic> postnatally diagnosed group in 5\/13 <jats:italic>vs<\/jats:italic> 1\/1 cases, respectively, at the 1\u2010min evaluation and 3\/13 <jats:italic>vs<\/jats:italic> 1\/1 cases, respectively, at the 5\u2010min evaluation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The prenatal diagnosis of Type\u2010III VP is challenging, with few cases reported in the literature; however, it is crucial for minimizing the risk of adverse outcome by enabling early\u2010term elective Cesarean delivery prior to rupture of membranes. Given that clinical manifestations and risk factors are non\u2010specific, and that Type\u2010III VP cannot be excluded when there is a normal cord insertion or a singular placental mass, systematic screening by transvaginal ultrasound in the general pregnant population is recommended, particularly in those with a low\u2010lying or morphologically abnormal placenta and those who conceived using assisted reproductive technology. \u00a9 2023 The Authors. <jats:italic>Ultrasound in Obstetrics &amp; Gynecology<\/jats:italic> published by John Wiley &amp; Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.26315","type":"journal-article","created":{"date-parts":[[2023,7,20]],"date-time":"2023-07-20T15:17:58Z","timestamp":1689866278000},"page":"24-33","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Prenatal diagnosis and postnatal outcome of <scp>Type\u2010III<\/scp> vasa previa: systematic review of literature"],"prefix":"10.1002","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8590-5743","authenticated-orcid":false,"given":"M.","family":"Pozzoni","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute  Milan Italy"},{"name":"Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Sammaria","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute  Milan Italy"},{"name":"Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Villanacci","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute  Milan Italy"},{"name":"Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Borgese","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute  Milan Italy"},{"name":"Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Ghisleri","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute  Milan Italy"},{"name":"Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6862-1810","authenticated-orcid":false,"given":"A.","family":"Farina","sequence":"additional","affiliation":[{"name":"Obstetric Unit IRCCS Azienda Ospedaliero\u00a0\u2013\u00a0Universitaria di Bologna  Bologna Italy"},{"name":"Department of Medical and Surgical Sciences (DIMEC) Alma Mater Studiorum\u00a0\u2013\u00a0University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Candiani","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute  Milan Italy"},{"name":"Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8097-366X","authenticated-orcid":false,"given":"P. 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