20 Questions
What is recommended prior to delivery for women with placenta praevia?
Reviewing indications for blood transfusion and hysterectomy
Why is it crucial to deliver women with placenta praevia in a maternity unit with on-site blood transfusion services?
To reduce the risk of massive obstetric haemorrhage
What is the reason for the wide variation in reported prevalence of placenta accreta?
Lack of standardized approach to imaging, clinical, and histopathological descriptions
What makes women with atypical antibodies a high-risk group in relation to placenta praevia?
They require discussions with haematologists and blood banks
Why is the term 'morbidly adherent placenta' considered misleading?
It fails to encompass the abnormally invasive end of the accreta spectrum
Why is prevention and treatment of anaemia recommended for women with placenta praevia?
To promote overall maternal well-being
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'
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
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.
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.
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.
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.
Who should be present as a minimum requirement for a planned caesarean section for a woman with placenta praevia?
Senior obstetrician and senior anaesthetist
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
What should be done when an emergency arises during a planned caesarean section for placenta praevia?
Alert the surgical team immediately
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
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
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
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
How was the care bundle for placenta accreta tested?
In a 5-month pilot study in six units
Learn about the delivery recommendations for women with placenta praevia according to RCOG Green-top Guideline No. 126. Understand the importance of discussions prior to delivery, review of indications for blood transfusion and hysterectomy, and considerations for declining blood or blood products.
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