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Placenta Praevia, Placenta Praevia Accreta and Vasa Praevia: Diagnosis and Management (Green-top Guideline No. 27)

Published: 05/01/2011

This is the third 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 Praevia Accreta: Diagnosis and Management. 


Update December 2014: New evidence and guidance in this field were reviewed in 2014 and it was decided that revision of this guideline would be deferred to a later date. The version available on the website and app will remain valid until replaced.


Maternal and fetal morbidity and mortality from placenta praevia and placenta praevia accreta are considerable and are associated with high demands on health resources. With the rising incidence of caesarean sections combined with increasing maternal age, the number of cases of placenta praevia and its complications, including placenta accreta, will continue to increase. In addition, vasa praevia, while rare, is nonetheless associated with high perinatal morbidity and mortality and is therefore included in this guideline for the first time.

The purpose of this guideline is to describe the diagnostic modalities used for placenta praevia, vasa praevia and a morbidly adherent placenta and how they are applied during the antenatal period. Clinical management is described in the antenatal and peripartum period with specific reference to the anticipation, planning and timing of surgery, as well as to the advanced techniques and interventions available for managing placenta accreta. This guideline does not address the problems of a suspected morbidly adherent placenta before fetal viability.