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Table 1 Key questions for the VP and VCI evidence summary and relationship to UK NSC screening criteria

From: Velamentous cord insertion: results from a rapid review of incidence, risk factors, adverse outcomes and screening

CriterionKey questions
1The condition should be an important health problem as judged by its frequency and/or severity. The epidemiology, incidence, prevalence and natural history of the condition should be understood, including development from latent to declared disease and/or there should be robust evidence about the association between the risk or disease marker and serious or treatable disease.What is the incidence of VP in the UK? (Q1)
What percentage of VP cases identified in the second trimester will resolve by late pregnancy? (Q2)
What is the risk of adverse perinatal outcomes in pregnancies associated with VP? (Q3)
What is the incidence of VCI in the UK? (Q6)
What is the risk of adverse perinatal outcomes in pregnancies associated with VCI? (Q7)
4There should be a simple, safe, precise and validated screening test.How effective is second-trimester TAS for detecting VP? (Q4)
How effective is second-trimester TAS for detecting VCI? (Q8)
9 and 109: There should be an effective intervention for patients identified through screening, with evidence that intervention at a pre-symptomatic phase leads to better outcomes for the screened individual compared with usual care. Evidence relating to wider benefits of screening, for example those relating to family members, should be taken into account where available. However, where there is no prospect of benefit for the individual screened then the screening programme should not be further considered.
10: There should be agreed evidence-based policies covering which individuals should be offered interventions and the appropriate intervention to be offered.
What is the most effective management pathway for women with screen-detected VP? (Q5)
What is the most effective management pathway for women with screen-detected VCI? (Q9)
  1. TAS transabdominal ultrasound scan, VCI velamentous cord insertion, VP vasa praevia