Antenatal diagnosis and selective management of abruptio placentae were studied prospectively over a 17-month period. Diagnosis was confirmed by placental inspection in 59 (1.3%) of 4545 deliveries. Among the 50 patients admitted with a living fetus, the diagnosis was made antenatally in 31 (62%). Fifteen were delivered vaginally and 16 by cesarean section. When these infants were compared to all other liveborn infants delivered during this period using a weight-adjusted chi 2 analysis, no significant difference was found in neonatal mortality or duration of hospitalization. There was a significant increase in the incidence of both respiratory distress syndrome and low Apgar scores among the study infants (P less than .005), but these increases were not correlated with mode of delivery or diagnosis-to-delivery interval. It is concluded that optimal fetal survival and an acceptable cesarean section rate may be obtained by selective management, especially in infants weighing more than 1500 g.