Vasa Previa- Hospital Stay and Delivery at 35 weeks- Sibley?

[Anonymous]

I was just diagnosed with vasa previa at 24.5 weeks and was told that, if it doesn't "resolve itself" (I'm not sure it ever fully does), I will have a hospital stay from 32-35 weeks and deliver via c section at 35 weeks. My OB delivers at Sibley. I understand that Sibley has a Level 2 NICU (which is lower than, say, Georgetown and GW)- has anyone had this experience at Sibley/have any feedback?

[Anonymous]

I was recently diagnosed with vasa previa by my OB, just when I went to the MFM they were confident that it was a complete placenta previa. Even with placenta previa my MFM strongly advised against delivering at Sibley. I will be delivering at 36 weeks. I dont think Sibley is really set up for the problems that could arise with either you or the baby. I would want to be at Georgetown or WHC if I were you.

[Anonymous]

I’m sorry you are dealing with this OP. I’ve never heard of this condition and just read up on it and it is extremely rare. It sounds like the major concerns are massive blood loss for you and the baby. Personally, I am not sure I would be comfortable delivering at a community hospital like Sibley with a risky condition like this. Ideally I would want to be at a hospital that is a level 1 trauma center and has a high grade NICU. In DC WHC and GW are level one trauma centers. Children’s is also a level one trauma center but you can’t deliver there. It is, however, connected by an underground tunnel to Children’s making transfer easier than from other locations. In terms of NICUs, I believe Georgetown and Children’s are level 4 (highest). GW and WHC are level 3.

Why don’t you talk to your doctor and see if it might be better for you to transfer care to a different hospital that offers higher levels of care, like GW or WHC? Given the rarity of this condition I’m not sure you will find many who have experienced it but maybe I am wrong.

[Anonymous]

I would not deliver a 35 weeker at Sibley, OP. You might need to consider other options. I had both kids there and it's a great hospital, but that was with very uneventful pregnancies.

[Anonymous]

I am a huge Sibley proponent and had a wonderful experience there with both of my babies. However, I had very easy pregnancies and deliveries with both of them. In your case, I think you would be better suited at Georgetown.

[Anonymous]

Sorry I mean WHC and Children’s are connected.

[Anonymous]

OP here- thanks all for the helpful responses! This is my first kid after a pretty drawn out IVF process so I am just trying to navigate this new world...

[Anonymous]

I’m sorry OP. I think the consensus is clear that you would be best served by a larger hospital that offers the highest level of care for your prenatal care and delivery. I think you and your baby would be very well served by the OB groups at WHC or GW. I have been to both practices and think you would be well served by either group. I think Georgetown could potentially be another option but I would make sure to discuss the potential drawbacks of the hospital not being a level 1 trauma center and what that could mean in the event of a major hemorrhage or other big complications. I would also want to discuss how the hospital ensures they have adequate blood products for deliveries that are riskier and what protocols they have in place if there is major bleeding. Since it sounds like this is a fairly rare condition, I might also choose an older OB who has more experience than someone young. And I would ask the OB directly how many women they have cared for with this complication. Don’t be afraid to advocate for yourself and your baby. You’ve worked so hard for your pregnancy and you deserve the best care you can get. It’s perfectly appropriate to transfer practices in the event of getting a diagnosis like you have. Perhaps your current OB may even have a colleague at one of those centers they could refer you to. Good luck and fingers crossed that this resolves for you without incident.

[Anonymous]

Hi OP. Im the first poster that was mis-diagnosed last month. I went down the rabit hole researching vasa previa for a while. I just wanted to say good luck! I hope the hospital stay goes well. I found a really informative facebook group that you might want to check out. I also went through infertility treatment and it seems that this is MUCH more common after ART (like 1 in 200 vs 1 in 2000). I found this statistic so incredible considering no one in the infertility treatment really talks about vasa previa as a potential outcome. Anyways, good luck and I hope it goes well!

[Anonymous]

You really should listen to the PPs and switch to an OB and MFM dr at Georgetown, WHC or GW. This isn’t just about the NICU. You have a serious medical condition that requires top specialists that have handled many cases like this- something doctors and nurses at Sibley don’t have the experience with. I would ask doctors how many of these cases they handle a yeast and go with the highest.

[Anonymous]

Op- have you found a good MFM??

[Anonymous]

Ah yes, another good suggestion PP. OP you definitely need one.

[Anonymous]

I was diagnosed with VP a few years ago. It was also my first pregnancy and I was planning on delivering at Sibley. After getting diagnosed, my OB recommended switching practices and delivering at a hospital with a more advanced NICU, so I wound up delivering at Holy Cross at 34 weeks.

My MFM was Dr. Gallagher, whom I loved. I switched to CWC for the main practice (but I didn’t love them).

My advice is to choose a hospital close to home with a high level NICU. Also look into NICUs that allow “rooming in” because the absolute hardest part for me was getting discharged and leaving my preemie at the hospital. (It was only a week or so, but it was rough.)

I managed to avoid the extended hospital stay before delivering, but some would say that was an unwise decision. In the end, I got a healthy baby, which is all that matters.

[Anonymous]

OP here again- thanks all for your advice! I am a patient at Bloom OB and they did not refer me to another OB who delivers at a higher NICU (after the vasa previa was identified). I have only seen one MFM specialist at my echocardiogram at Sibley, but I believe she was actually from Childrens. Next steps sound like investigating transferring to an OB who delivers at GW or Georgetown (as those are both closest to me) (depending on how relevant the Level 1 Trauma Center could be for this issue). Thanks again for all of the comprehensive and thoughtful responses!

[Anonymous]

Generally the only OBs who can deliver at GW and GT are their own in-house practices. Some of the solo OBs have privileges at GT for premature or very high risk deliveries.

An advantage of going to GW or GT is that in addition to the OBs, they also have MFMs and (hypothetically....) they all work together, records are seemless, that sort of thing. I think some of the MFMs may even do deliveries. Some other posters here can probably give you the names of those docs and I would call and get an appointment with those and see who you like best.