RCOG Green-top Guideline No. 126 Placenta Praevia Delivery Recommendations

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What is recommended prior to delivery for women with placenta praevia?

Declining blood or blood products
Reviewing indications for blood transfusion and hysterectomy (correct)
Having a discussion with partners about delivery
Avoiding any discussion about delivery

Why is it crucial to deliver women with placenta praevia in a maternity unit with on-site blood transfusion services?

To increase the chances of a hysterectomy
To avoid any treatment for anaemia
To reduce the risk of massive obstetric haemorrhage (correct)
To avoid any discussions with the local haematologist

What is the reason for the wide variation in reported prevalence of placenta accreta?

Genetic predisposition in affected individuals
Lack of standardized approach to imaging, clinical, and histopathological descriptions (correct)
Inadequate medical resources in certain regions
Overreliance on a single diagnostic test

What makes women with atypical antibodies a high-risk group in relation to placenta praevia?

They require discussions with haematologists and blood banks (D) Signup and view all the answers

Why is the term 'morbidly adherent placenta' considered misleading?

It fails to encompass the abnormally invasive end of the accreta spectrum (A) Signup and view all the answers

Why is prevention and treatment of anaemia recommended for women with placenta praevia?

To promote overall maternal well-being (C) Signup and view all the answers

What terminology should be used to include both the abnormally adherent and invasive forms of accreta placentation?

'Placenta accreta spectrum' or 'abnormally adherent and invasive placenta' (A) Signup and view all the answers

How have recent large series contributed to improving maternal outcomes in cases of placenta percreta?

By lowering rates of maternal death through better screening and planning at specialist centers (C) Signup and view all the answers

What is the recommendation regarding tocolysis for women with symptomatic placenta praevia or low-lying placenta if delivery is indicated based on maternal or fetal concerns?

Tocolysis should be stopped immediately. (C) Signup and view all the answers

Based on the results of the RCT mentioned in the text, what was the outcome related to the prolonged use of tocolytics in women with symptomatic preterm placenta praevia?

The results did not reach significance when combining data from retrospective studies. (C) Signup and view all the answers

What was the main finding of the randomised, double-blind, placebo-controlled multicentre trial regarding nifedipine and placebo in women with placenta praevia bleeding and intact membranes?

There was no difference in the prolongation of pregnancy between nifedipine and placebo groups. (A) Signup and view all the answers

In the context of using tocolysis for placenta praevia, why was the RCT mentioned in the text judged inadequately compliant with the Consolidated Standards of Reporting Trials statement?

The RCT did not meet the standards for reporting clinical trials. (A) Signup and view all the answers

Who should be present as a minimum requirement for a planned caesarean section for a woman with placenta praevia?

Senior obstetrician and senior anaesthetist (C) Signup and view all the answers

What has been recommended for women at high risk of emergency transfusion, such as those with placenta praevia and no clinically significant alloantibodies?

Weekly group and screen samples (D) Signup and view all the answers

What should be done when an emergency arises during a planned caesarean section for placenta praevia?

Alert the surgical team immediately (B) Signup and view all the answers

Why is it important to send group and screen samples once a week for women at high risk of emergency transfusion?

To identify new antibody formation (D) Signup and view all the answers

What type of healthcare professionals should be involved in managing the elective delivery of women with placenta accreta spectrum?

Senior anesthetists, obstetricians, and gynecologists with appropriate experience (C) Signup and view all the answers

In the situation of increta or percreta confirmed at surgery, what is recommended if a woman refuses donor blood transfusion?

Transferring her to a unit with a cell saver (C) Signup and view all the answers

What action did the National Patient Safety Agency, RCOG, and the Royal College of Midwives take regarding placenta accreta?

Set up an expert working group to develop a care bundle (A) Signup and view all the answers

How was the care bundle for placenta accreta tested?

In a 5-month pilot study in six units (D) Signup and view all the answers