Maternal and Perinatal Morbidity Resulting from Placenta Previa

One hundred forty-seven cases of partial or complete placenta previa from 1975 to 1982 were reviewed. A history of prior cesarean section was associated with a significant increase in maternal morbidity, including massive hemorrhage, placenta accreta, and hysterectomy. Despite tocolysis and transfusions to delay delivery, nearly two-thirds of the patients were delivered before 36 weeks' gestation. Onset of bleeding before 20 weeks' gestation was associated with a very poor fetal prognosis. The perinatal mortality rate was 81 of 1000. The overall incidence of respiratory distress syndrome was 22%; this was a major cause of neonatal mortality and morbidity. There was a statistically significant correlation between antepartum maternal hemorrhage and the need for neonatal transfusion, and between the neonatal anemia and the amount of intrapartum maternal blood loss.