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[Cesarean section for placenta praevia. Perinatal mortality and morbidity]
Revue Francaise De Gynecologie Et D'Obstetrique
|December 1, 1986
Summary
Placenta previa, a severe condition, leads to significant fetal complications like prematurity and anemia. Early diagnosis and management, including bed rest and timely cesarean delivery, can improve outcomes for affected newborns.
Area of Science:
- Obstetrics and Gynecology
- Perinatology
- Fetal Medicine
Context:
- Placenta previa presents significant risks for perinatal mortality and fetal complications.
- Cesarean delivery for placenta previa necessitates careful analysis of associated fetal issues.
Purpose:
- To analyze fetal complications, their frequency, prognosis, and associated obstetrical factors in 65 children born via cesarean for placenta previa.
- To propose a management strategy for low placental insertions based on fetal outcomes.
Summary:
- The study identified high rates of prematurity, anemia, and respiratory complications (respiratory distress, amniotic fluid inhalation, hyaline membrane disease) in neonates born via cesarean for placenta previa.
- Infection and hemorrhage were noted as primary complications, often linked to overlapping placenta previa and repeated bleeding episodes.
- Fetal hypotrophy was infrequent, but mortality reached 3%.
Impact:
- The findings support a management approach involving early sonogram diagnosis, bed rest, and planned cesarean delivery at 35 weeks of amenorrhea.
- Earlier intervention is recommended in cases of hemorrhage or when maternal/fetal conditions preclude conservative management aimed at reducing prematurity.