The purpose of this guideline is to describe the diagnostic modalities and review the evidence-based approach to the clinical care of pregnancies complicated by placenta praevia and placenta accreta spectrum.
Placenta praevia and placenta accreta spectrum are associated with high maternal and neonatal morbidity and mortality, due to antepartum haemorrhage and/or major obstetric haemorrhage during birth and preterm birth.
Rates of both placenta praevia and accreta have increased. They are likely to continue doing so as a result of rising rates of caesarean births and the use of assisted reproductive technology, particularly in vitro fertilization.
The highest rates of complication for both the woman and their newborn are observed when these conditions co-exist and are only diagnosed during birth.
Version history
This is the fifth edition of this guideline. The first, published in 2001, was entitled Placenta Praevia: Diagnosis and Management; the second, published in 2005, was entitled Placenta Praevia and Placenta Accreta: Diagnosis and Management; the third, published in 2011, was entitled Placenta Praevia, Placenta Accreta and Vasa Praevia: Diagnosis and Management, and the fourth was divided into Green-top Guideline no. 27a Placenta Praevia, Placenta Accreta Diagnosis and Management and Green-top Guideline no. 27b Vasa Praevia: Diagnosis and Management.
Review will commence in 2029, unless otherwise indicated.
Developers’ declaration of interest
- Professor ERM Jauniaux FRCOG, London: None declared.
- Professor Bhide FRCOG, London: None declared.
- Professor M Hussein, Cairo, Egypt: None declared.
- Professor Christoph Lees FRCOG, London: Professor Lees has received funding from Samsung (Seoul) and GE Healthcare both personally and to the institution in relation to lectures on ultrasound imaging in placenta accreta spectrum.
- Professor F D'Antonio, Chieti, Italy: None declared.
- Professor SC Robson FRCOG, Newcastle: Professor Robson has participated and was clinical lead in the North East and North Cumbria LMNS Quality and Safety Group and Board. All other authors have declared no conflicts of interest.
- Dr A Kaelin MRCOG, Liverpool: None declared.
- Professor D Jurkovic FRCOG, London: None declared.