Clinical significances of magnetic resonance imaging in prenatal diagnosis of vasa previa in a woman with bilobed placentas

We report a case of a pregnant woman diagnosed as having vasa previa by magnetic resonance imaging (MRI). A parous woman was referred to our hospital at 31 weeks of gestation due to suspicion of placenta previa. Transvaginal ultrasound examination together with the Doppler techniques showed a fetal vessel on a lesion of low and high mixed echogenecities over the internal os, but could not confirm whether it was placental tissue or not. MRI demonstrated that it was not placenta but a hemorrhage between bilobed placentas and that the vessel was running over the internal os freely from the placenta. At 34 weeks of gestation, emergency cesarean section was performed due to increasing vaginal bleeding. MRI should be useful in the diagnosis of vasa previa when the relation between the position of the placenta and that of suspicious vessels cannot be adequately evaluated by ultrasound.