An audit to review the characteristics and management of placenta praevia at Aberdeen Maternity Hospital, 2009–2011

Abstract

Placenta praevia (PP) is an important cause of maternal and fetal morbidity. We reviewed the characteristics and management of PP at the Aberdeen Maternity Hospital (AMH) to evaluate performance. In the years 2009–2011, a total of 60 cases with confirmed PP underwent caesarean section (CS) at the AMH. Two-fifths of cases had previous CS and two-thirds were posterior praevias. Four-fifths were major praevias. Diagnosis was mostly by trans-abdominal scanning (TAS). A little less than two-thirds underwent hospital admission (half of them for antepartum haemorrhage). Most received steroid and ferrous sulphate as appropriate. The majority were delivered at greater than 36 weeks’ gestation. There was good support in theatre by senior obstetricians and anaesthetists. Cell salvage was used in theatre. Overall, the outcomes were good. Improvements could be made on documentation of counselling preoperatively and practice of trans-vaginal scans (TVS) to confirm low lying placentae even at the 20-week scan for better diagnosis, as per the RCOG guidelines.