Placenta Praevia, Placenta Accreta and Vasa Praevia
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As the caesarean section rate continues to increase the number of patients with placenta praevia and placenta accreta also increases. The prenatal diagnosis of vasa praevia has also become more prevalent with improvements in ultrasound detection. These patients form a high-risk group at risk of major obstetric haemorrhage with implications for both mother and baby. Antenatal diagnosis relies on vigilance at the anomaly scan and subsequent imaging for confirmation including MRI. Antenatal admission may be required to reduce the risk of major haemorrhage outside the hospital environment. Delivery needs to be planned to employ the wider multi-disciplinary team to reduce both maternal and neonatal complications. The mainstay of treatment for placenta accreta will be caesarean hysterectomy, but a proportion of women may be managed more conservatively.
KeywordsPlacenta praevia Placenta accreta Vasa praevia Morbidly adherent placenta Obstetric haemorrhage Antepartum haemorrhage Litigation
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