[Cesarean section for placenta praevia. Perinatal mortality and morbidity].

The severity of placenta praevia is well known and responsible of a non negligible perinatal mortality. This study relates to 65 children born after a cesarean section for placenta praevia and analyzes the fetal complications, their frequency, their prognosis as well as the obstetrical factors connected to this problem. Mortality is 3%, prematurity remains high and so is the anemia, but hypotrophy is rare. The main complications are infection essentially due to an overlapping placenta praevia, its hemorrhagic nature and the increasing number of hemorrhagic episodes and respiratory complications (respiratory distress, inhalation of amniotic fluid and hyaline membrane disease). From these fetal data, the authors propose a method of management of low placental insertions consisting essentially of bed rest as soon as the diagnosis in made on the sonogram, and extraction at the 35th week of amenorrhea. In case of hemorrhage, extraction must be performed earlier if obstetrical conditions, maternal as well as fetal, do not permit to undertake a conservative approach aimed essentially to decrease prematurity and its consequences.