What immediate management steps should be taken if vasa praevia is suspected during labour?

If vasa praevia is suspected during labour, the immediate management steps include:

• Transfer the woman to obstetric-led care immediately to ensure access to specialist resources and continuous monitoring ¹.
• Establish venous access promptly to allow for rapid fluid resuscitation if bleeding occurs ¹.
• Start continuous cardiotocography (CTG) to monitor the fetal heart rate continuously, as fetal compromise can occur rapidly ¹.
• Monitor maternal vital signs closely and assess vaginal blood loss carefully, distinguishing it from a normal show ¹.
• Take blood samples urgently for full blood count, blood group, and cross-matching in preparation for possible transfusion ¹.
• Seek immediate senior obstetric and anaesthetic advice and involve a multidisciplinary team including senior midwife and labour ward coordinator to plan urgent delivery ¹.
• Prepare for expedited birth, usually by emergency caesarean section, to prevent fetal exsanguination due to ruptured fetal vessels ¹.
• Administer intravenous fluids urgently if there is significant bleeding or maternal instability ¹.