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
The first edition of this guideline was published in 2001 (as Placenta Praevia: Diagnosis and Management); the second edition was published in 2005 (as Placenta Praevia and Placenta Praevia Accreta: Diagnosis and Management); the third edition was published in 2011 (as Placenta Praevia, Placenta Praevia Accreta and Vasa Praevia: Diagnosis and Management.); the fourth edition of this guideline was published in 2018. This is the fifth edition of this guideline published in 2026. Next review due: 2029.
The management and diagnosis of vasa praevia is addressed in Green-top Guideline No. 27b Vasa Praevia: Diagnosis and Management.
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.