We are pleased to advise that deep linking capability, enabling users to directly download individual mobile toolkits, has now been released on the RDS mobile app. When you install the update, you will see that each toolkit has a small QR code icon the header area beside the search icon – see screenshot below. Clicking on this icon will open up a window with a full-size QR code and the alternative of a short URL for sharing with users. Instructions are provided.
You may need to actively install the update to install RDS app version 4.7.1 to see this improvement. Installing this update is also strongly recommended to get the full benefits of the new contingency arrangements – specifically, that if the RDS website should fail, you will still be able to download new mobile app toolkits.
To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number. To install latest updates:
On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.
On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.
Please get in touch with ann.wales3@nhs.scot with any questions.
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Antenatal
There is currently no evidence to support screening all women for vasa praevia at the routine FAS.
However for those at higher risk of vasa praeva, (presence of a succenturiate lobe or low lying placenta), a combination of both TA and TV colour Doppler imaging ultrasonography provides the best diagnostic accuracy and performing this at the time of the routine fetal anomaly scan has a high diagnostic accuracy with low false positive rate. However, further research is required to determine the benefit of this.
All patients with suspected vasa praevia should have this confirmed by a further ultrasound in the third trimester
Intrapartum
Vasa praevia may be diagnosed during early labour during vaginal examination by;
Fetal mortality rate after rupture is at least 60% despite urgent Caesarean section.
If Vasa praevia is confirmed in the third trimester, deliver by elective Caesarean section between 34 -36 weeks.
Administer antenatal corticosteroids for fetal lung maturity from 32 weeks due to the increased risk of preterm delivery.
Tailor decisions for prophylactic hospitalisation from 30-32 weeks to individual patients, taking into account risk factors such as multiple pregnancy, antenatal bleeding and threatened preterm labour. Outpatient care has been associated with excellent outcomes in asymptomatic women.
Perform an emergency Caesarean section for patients with known Vasa Praevia at viable gestations with SROM and or labour without delay.
If ruptured Vasa Praevia is suspected do not delay delivery while trying to confirm the diagnosis.
Urgent Caesarean section and neonatal resuscitation, including the use of blood transfusion if required, is essential in the management of ruptured vasa praevia diagnosed during labour.
Send the placenta for pathological examination to confirm the diagnosis. This is particularly important where there has been a still birth or where there has been acute fetal compromise during delivery
Offer a post-natal debrief consultation
