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.