Guideline No. 402: Diagnosis and Management of Placenta Previa

Venu Jain, Hayley Bos, Emmanuel Bujold
Journal of Obstetrics and Gynaecology Canada: JOGC 2020, 42 (7): 906-917.e1

OBJECTIVES: To summarize the current evidence and to make recommendations for diagnosis and classification of placenta previa and for managing the care of women with this diagnosis.

OPTIONS: To manage in hospital or as an outpatient and to perform a cesarean delivery preterm or at term or to allow a trial of labour when a diagnosis of placenta previa or a low-lying placenta is suspected or confirmed.

OUTCOMES: Prolonged hospitalization, preterm birth, rate of cesarean delivery, maternal morbidity and mortality, and postnatal morbidity and mortality.

INTENDED USERS: Family physicians, obstetricians, midwives, and other maternal care providers.

TARGET POPULATION: Pregnant women with placenta previa or low-lying placenta.

EVIDENCE: Medline, PubMed, Embase, and the Cochrane Library were searched from inception to October 2018. Medical Subject Heading (MeSH) terms and key words related to pregnancy, placenta previa, low-lying placenta, antepartum hemorrhage, short cervical length, preterm labour, and cesarean. This document represents an abstraction of the evidence rather than a methodological review.

VALIDATION METHODS: This guideline has been reviewed by the Maternal-Fetal Medicine and Diagnostic Imaging committees of the Society of Obstetricians and Gynaecologists of Canada (SOGC) and approved by the SOGC Board of Directors.

BENEFITS, HARMS, AND/OR COSTS: Women with placenta previa or low-lying placenta are at increased risk of maternal, fetal and postnatal adverse outcomes that include a potentially incorrect diagnosis and possibly unnecessary hospitalization, restriction of activities, early delivery, or cesarean delivery. Optimization of diagnosis and management protocols has potential to improve maternal, fetal and postnatal outcomes.


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