Vasa previa is a rare but critical obstetric condition in which unprotected fetal vessels traverse the membranes within the lower uterine segment, placing the fetus at significant risk of rapid exsanguination if membranes rupture. This presentation provides a structured overview of the condition, emphasizing its clinical relevance in modern fetal medicine. The session begins with an exploration of the pathophysiology and epidemiology of vasa previa, highlighting its association with adverse perinatal outcomes and the importance of antenatal detection. The three principal types—Type I, involving velamentous cord insertion, Type II, associated with vessels connecting a succenturiate or bilobed placenta and Type III single placental mass with normal cord insertion but a aberrant vessel traversiong the —are clearly delineated to aid diagnostic clarity. A detailed review of imaging features follows, focusing on the pivotal role of transvaginal ultrasound with color Doppler in identifying fetal vessels overlying or near the internal os. Key sonographic signs, diagnostic pitfalls, and strategies to improve detection rates are discussed, along with the value of targeted screening in high‑risk pregnancies. Management considerations are then addressed, including antenatal surveillance, timing of delivery, and intrapartum precautions aimed at preventing vessel rupture and optimizing neonatal outcomes. The presentation concludes by reinforcing the central message: timely recognition and proactive management of vasa previa dramatically improve perinatal survival. Through systematic evaluation, standardized imaging protocols, and coordinated multidisciplinary care, clinicians can transform a historically catastrophic condition into one with excellent outcomes.

Karthik Senthilvel is a fetal medicine specialist and clinical geneticist with advanced training and a strong academic footprint. He completed his MBBS at SRM Medical College, Chennai in 2011, followed by an MD in Radiology in 2017, establishing a solid foundation in high‑precision imaging and fetal diagnostics. He is the Founder and Clinical Head of Karu Fetal Diagnosis, Therapy, Genetics and Research Institute, where he leads comprehensive prenatal diagnostic, therapeutic, and genetic services. He is certified in fetal interventions by the Fetal Medicine Foundation (UK) and holds the Advanced University Certificate in Maternal–Fetal Medicine from Barcelona. He also completed a post‑doctoral fellowship in Clinical Genetics at NIMS. His academic contributions include six publications, three textbook chapters, five peer reviews, and over 50 presentations at national and international forums. He serves as Secretary of the Society of Fetal Medicine – Tamil Nadu Chapter, ICRI Fetal Radiology Fellowship Examiner, and Section Editor (YuWa) for the Journal of Fetal Radiology. He has contributed to national ICRI guidelines on anomaly scans and Doppler protocols and received the Samrakshan Yodha Five-Star Award and an award of recognition by the Global South Alliance for Safe Motherhood and the National IRIA.