[Benckiser's hemorrhage: severe and inevitable?]

Abstract

Benckiser's hemorrhage is a rare affection associated with 75-100% neonatal mortality. It is due to the rupture of one or more velamentous and previa vessels. We report two cases, one of which was fatal for the child despite immediate neonatal management. This illustrates how difficult the obstetrical and neonatal management of this affection is. Risk factors for velamentous insertion of the cord and vasa previa are multiple pregnancies, low lying placenta, bilobed and succenturiate-lobed placenta. First we specify the pathophyisiological implication of this severe hemorrhage, then the means to diagnose fetal bleeding or vasa previa. This knowledge could allow us to develop strategies to screen women sonographically to detect vasa previa. Unfortunately the benefits, risks, limits and cost of such strategies remain unknown.