References

Arias F Cervical cerclage for the temporary treatment of patients with placenta previa. Obstet Gynecol. 1988; 71:(4)545-8

Becker RH, Vonk R, Mende BC, Ragosch V, Entezami M The relevance of placental location at 20–23 gestational weeks for prediction of placenta previa at delivery: evaluation of 8650 cases. Ultrasound Obstet Gynecol. 2001; 7:(6)496-501

Bhide A, Prefumo F, Moore J, Hollis B, Thilaganathan B Placental edge to internal os distance in the late third trimester and mode of delivery in placenta previa. BJOG. 2003; 110:(9)860-4

Chou MM, Tseng JJ, Ho ES, Hwang JI Three-dimensional color power Doppler imaging in the assessment of uteroplacental neovascularization in placenta previa increta/percreta. Am J Obstet Gynecol. 2001; 185:(5)1257-60

Saving Mothers' Lives: Reviewing maternal deaths to make motherhood safer – 2003–2005.London: CEMACH; 2007

Dashe JS, McIntire DD, Ramus RM, Santos-Ramos R, Twickler DM Persistence of placenta previa according to gestational age at ultrasound detection. Obstet Gynecol. 2002; 99:(5 Pt 1)692-7

Dawson WB, Dumas MD, Romano WM, Gagnon R, Gratton RJ, Mowbray D Translabial ultrasonography and placenta previa: does measurement of the os-placental distance predict outcome?. J Ultrasound Med. 1996; 15:(6)441-6

Edlestone DI Placental localization by ultrasound. Clin Obstet Gynecol. 1977; 20:(2)285-7

Faiz AS, Ananth CV Etiology and risk factors for placenta previa: an overview and meta-analysis of observational studies. J Matern Fetal Neonatal Med. 2003; 13:(3)175-90

Farine D, Fox HE, Jakobson S, Timor-Tritsch IE Vaginal ultrasound for diagnosis of placenta previa. Am J Obstet Gynecol. 1988; 159:(3)566-9

Frederiksen MC, Glasenberg R, Stika CS Placenta previa: a 22-year analysis. Am J Obstet Gynecol. 1999; 180:(6 Pt 1)1432-7

Health and Social Care Information Centre. NHS Maternity Statistics – 2005-2006. 2007. http://www.hscic.gov.uk/catalogue/PUB01682/nhs-mater-2005-2006-rep.pdf (accessed 20 January 2015)

Hill LM, Di Nofrio DM, Chenevey P Transvaginal sonographic evaluation of first-trimester placenta previa. Ultrasound Obstet Gynecol. 1995; 5:301-3

Gielchinsky Y, Rojansky N, Fasouliotis SJ, Ezra Y Placenta accreta–summary of 10 years: a survey of 310 cases. Placenta. 2002; 23:210-4

Ghourab S, Al-Jabari A Placental migration and mode of delivery in placenta previa: transvaginal sonographic assessment during the third trimester. Ann Saudi Med. 2000; 20:(5-6)382-5

Gurol-Urganci I, Cromwell DA, Edozien LC, Smith GC, Onwere C, Mahmood TA, Templeton A, van der Meulen JH Risk of placenta previa in second birth after first birth cesarean section: a population-based study and meta-analysis. BMC Pregnancy Childbirth. 2011; 11 https://doi.org/10.1186/1471-2393-11-95

Laughon SK, Wolfe HM, Visco AG Prior cesarean and the risk for placenta previa on second-trimester ultrasonography. Obstet Gynecol. 2005; 105:962-5

Lauria MR, Smith RS, Treadwell MC, Comstock CH, Kirk JS, Lee W, Bottoms SF The use of second-trimester transvaginal sonography topredict placenta previa. Ultrasound Obstet Gynecol. 1996; 8:337-40

Leerentveld RA, Gilberts ECAM, Arnold KJCW, Wladimiroff JW Accuracy and safety of transvaginal sonographic placental localization. Obstet Gynecol. 1990; 76:759-62

Love CD, Wallace EM Pregnancies complicated by placenta praevia: what is appropriate management?. Br J Obstet Gynaecol. 1996; 103:864-7

Love CD, Fernando KJ, Sargent L, Hughes RG Major placenta praevia should not preclude out-patient management. Eur J Obstet Gynaecol Repr Biol. 2004; 117:24-9

King DL Placental ultrasonography. JCU. 1973; 1:21-6

McClure N, Dorman JC Early identification of placenta praevia. Br J Obstet Gynaecol. 1990; 97:959-61

Miller DA, Chollet JA, Goodwin TM Clinical risk factors for placenta praevia–placenta accreta. Am J Obstet Gynecol. 1997; 177:210-4

Mustafá SA, Brizot ML, Carvalho MH, Watanabe L, Kahhale S, Zugaib M Transvaginal ultrasonography in predicting placenta previa at delivery: a longitudinal study. Ultrasound Obstet Gynecol. 2002; 20:356-9

Neilson JP Interventions for suspected placenta praevia. Cochrane Database Syst Rev. 2003; 2003:(2)

London: NICE; 2014

Oppenheimer LCanada: SOGC; 2007

Oppenheimer L, Holmes P, Simpson N, Dabrowski A Diagnosis of low-lying placenta: can migration in the third trimester predict outcome?. Ultrasound Obstet Gynecol. 2001; 18:100-2

Oyelese Y, Catanzarite V, Prefumo F, Lashley S, Schachter M, Tovbin Y Vasa previa: the impact of prenatal diagnosis onoutcomes. Obstet Gynecol. 2004; 103:937-42

Parekh N, Husaini SW, Russel IF Caesarean section for placenta praevia: a retrospective study of anaesthetic management. Br J Anaesth. 2000; 84:725-30

Paterson-Brown S, Singh C Developing a care bundle for the management of suspected placenta accreta. Obstet Gynecol. 2010; 12:21-7

Rosati P, Guariglia L Clinical significance of placenta previa detected at early routine transvaginal scan. Ultrasound Med. 2000; 19:581-5

Melbourne, Australia: RANZCOG; 2003

London: RCOG; 2010

London: RCOG; 2011

Royal College of Obstetricians and Gynaecologists. Placenta praevia after caesarean section care bundle. 2010. http://www.nrls.npsa.nhs.uk/EasySiteWeb/GatewayLink.aspx?alId=66276 (accessed 15 January 2015)

Sallout B, Oppenheimer LW The classification of placenta previa based on os-placental edge distance at transvaginal sonography.2002

Schachter M, Tovbin Y, Arieli S, Friendler S, Ron-El R, Sherman D In vitro fertilization is a risk factor for vasa previa. Fertil Steril. 2002; 78:642-3

Shih JC, Palacios JM, Su YN, Shyu MK, Lin CH, Lin SY Role of three-dimensional power Doppler in the antenatal diagnosis of placenta accreta: comparison with gray-scale and color Doppler techniques. Ultrasound Obstet Gynecol. 2009; 33:193-203

Silver RM, Landon MB, Rouse DJ, Leveno KJ, Spong CY, Thom EA Maternal morbidity associated with multiple repeat cesarean deliveries. Obstet Gynecol. 2006; 107:1226-32

Smith RS, Lauria MR, Comstock CH, Treadwell MC, Kirk JS, Lee W Transvaginal ultrasonography for all placentas that appear to be low-lying or over the internal cervical os. Ultrasound Obstet Gynecol. 1997; 9:22-4

Placenta praevia: Diagnosis and management

02 February 2015
11 min read
Volume 23 · Issue 2

Abstract

Placenta praevia occurs when the placenta implants in the lower uterine segment. It is often first diagnosed at the 20-week routine anomaly scan and affects approximately 1:200 women. Placenta praevia is associated with high levels of maternal morbidity and therefore presents a significant challenge for women and care providers. The management of this obstetric complication requires a multidisciplinary approach to antenatal diagnosis and monitoring, birth planning and postnatal care to improve maternal and neonatal outcomes.

Placental development begins upon implantation of the blastocyst into the maternal endometrium during the initial stages of human embryogenesis. Implantation involves localisation to the most optimal position; most commonly the mid-to upper-anterior or posterior uterine wall. This physiological process can be defective and in approximately 6.3 per 1000 pregnancies (Health and Social Care Information Centre, 2007) the pathophysiological condition known as placenta praevia occurs.

Placenta praevia is characterised by either whole or partial implantation of the placenta in the lower uterine segment (Figure 1). Pregnancy complicated by placenta praevia or placenta accreta presents numerous and varied challenges for both the woman and her maternity care team due to the associated levels of maternal and fetal morbidity and significant demand on health resources (Royal College of Obstetricians and Gynaecologists (RCOG), 2011). When insertion of the placenta pervades the deciduas basilis and through the myometrium, a morbidly adherent placenta (placenta accreta) is indicated (RCOG, 2011). A continuous increase in the incidence of placenta praevia, including placenta accreta, is anticipated due to rising caesarean rates. It is suggested that the damage caused to the myometrium and endometrium due to surgical disruption of the uterine cavity during caesarean section is linked with an increased risk of placenta praevia in a subsequent pregnancy (Faiz and Ananth, 2003). More recent studies regarding risk factors for placenta praevia support this and additionally link placenta praevia to increased maternal age, multiple gestation, high parity and smoking (Gurol-Urganci et al, 2011).

Register now to continue reading

Thank you for visiting British Journal of Midwifery and reading some of our peer-reviewed resources for midwives. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to our clinical or professional articles

  • Unlimited access to the latest news, blogs and video content

  • Monthly email newsletter