[Placenta previa: maternal and fetal prognosis covering 128 consecutive cases from the Brazzaville University...

The aim of this study was to determine the frequency of placenta previa (PP) in our hospital; to assess the maternal and fetal prognosis; to specify its location, the term at occurrence, and the mode of childbirth; and to propose preventive measures to improve its management.

This retrospective study covers a 5-year period from 1 January, 1998, to 31 December, 2002, and 128 cases of PP at the maternity ward of the Brazzaville University Hospital Center. The frequency of this complication during the study period was 0.6%; 54.6% of the women were 26-35 years old; most had two or more previous pregnancies (72.7%) and two or more previous deliveries (73.6%). The central (total) variant was most common (84.4%). Most children (71.9%) were born before term, and even more (85.2%) delivered by cesarean; 43.8% of the new-borns had 1-min Apgar scores of at least 7; 53.1% weighed less than 2500 g at birth and 44.5% (57) were premature. The principal postpartum morbidity involved: endometritis, 3 cases (2.3%); parietal suppuration after cesarean, 7 cases (5.5%); and maternal anemia, 11 cases (8.6%). There were also 7 (5.5%) still-births and 12 (9.4%) early neonatal deaths. Causes of neonatal death included cerebral distress, neonatal infection, and complications of Hirschprung disease.

PP remains a serious disease of pregnancy. Improving the maternal and fetal prognosis requires intensification of antenatal consultations, ultrasound examinations that enable the location of placental insertion to be identified, and timely cesarean delivery once the infant is sufficiently mature.