{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T19:44:59Z","timestamp":1791229499836,"version":"4.1.0"},"reference-count":44,"publisher":"Georg Thieme Verlag KG","issue":"S 01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:p>\n            Objective\u2003We aimed to compare costs of two strategies for third-trimester type II vasa previa management: (1) fetoscopic laser ablation surgery (FLS) referral and (2) standard management (SM).<\/jats:p><jats:p>\n            Study Design\u2003A decision analytic model and cost-benefit analysis from a health care perspective were performed. The population included patients with type II vasa previa at approximately 32 weeks. SM entailed 32-week antepartum admission and cesarean at approximately 35 weeks. FLS referral included consultation and possible laser surgery at 32 weeks for willing\/eligible candidates. Successful laser surgery allowed the possibility of term vaginal delivery. Outcomes included antepartum admission, preterm birth, cesarean, neonatal transfusion, and death. Sensitivity analyses were performed.<\/jats:p><jats:p>\n            Results\u2003In base case analysis, FLS referral was cost saving compared with SM (total cost per patient $65,717.10 vs. 71,628.16). FLS referrals yielded fewer antepartum admissions, cesareans, premature births, neonatal transfusions, and deaths. Eligible referred patients choosing FLS incurred a total cost of $41,702.46, a &gt;40% decrease compared with SM. FLS referral was cost saving in all one-way sensitivity analyses except when antepartum admission costs were low. In threshold analyses, FLS referral was cost saving unless laser surgery cost was &gt;$39,892 (2.75x expected cost), antepartum admission cost for monitoring of vasa previa or ruptured membranes was &lt;$7,455, &lt;11% patients were eligible for laser surgery, and when &lt;12% of eligible patients chose laser surgery. In two-way sensitivity analysis, FLS referral was cost saving except at very high laser surgery costs and extremely low antepartum admission costs.<\/jats:p><jats:p>\n            Conclusion\u2003Referral for FLS for type II vasa previa was cost saving and improved outcomes compared with SM, despite upfront costs, fetoscopy-related risks, and many patients being ineligible or not opting for surgery after referral.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0043-1771262","type":"journal-article","created":{"date-parts":[[2023,7,26]],"date-time":"2023-07-26T19:06:26Z","timestamp":1690398386000},"page":"e2454-e2462","source":"Crossref","is-referenced-by-count":4,"special_numbering":"S","title":["Fetoscopic Laser Ablation of Type II Vasa Previa: A Cost Benefit Analysis"],"prefix":"10.1055","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1750-2157","authenticated-orcid":false,"given":"Martha A.","family":"Monson","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Intermountain Health, Salt Lake City, Utah"},{"name":"Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramen H.","family":"Chmait","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brett","family":"Einerson","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Intermountain Health, Salt Lake City, Utah"},{"name":"Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,7,21]]},"reference":[{"issue":"05","key":"ref1","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1016\/j.ajog.2015.08.031","article-title":"#37: Diagnosis and management of vasa previa","volume":"213","author":"R G Sinkey","year":"2015","journal-title":"Am J Obstet Gynecol"},{"issue":"05","key":"ref2","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1002\/uog.23520","article-title":"How to screen for vasa previa","volume":"57","author":"A C Ranzini","year":"2021","journal-title":"Ultrasound Obstet Gynecol"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1097\/01.AOG.0000123245.48645.98","article-title":"Vasa previa: the impact of prenatal diagnosis on outcomes","volume":"103","author":"Y Oyelese","year":"2004","journal-title":"Obstet 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