Placenta previa: An evaluation of expectant management and the factors responsible for fetal wastage

Abstract

1.1. Two hundred and twenty-six cases of placenta previa with a total perinatal mortality rate of 12.4 per cent are reviewed.2.2. The fetal mortality rate in the 123 cases of partial placenta previa was 5.7 per cent and 20.4 per cent in the 103 cases of total placenta previa.3.3. The factors responsible for the perinatal wastage are discussed.4.4. A uterine incision through the placental site does not appear to increase the perinatal loss.5.5. Expectancy offered no advantages to 45 per cent of the cases because the infant was of term size. In another 21 per cent, despite prematurity, maternal and fetal indications dictated immediate delivery.6.6. Expectant management was feasible in only 34 per cent of the cases. In this group, expectancy increased the perinatal salvage so that it approximated that of the immediately treated group.7.7. Thus, two decades after the introduction of expectant management, the problem of prevention of prematurity and intrauterine anoxia still remains.