Updated guidance on placenta complications

By Julie Griffiths on 27 September 2018 Pregnancy Placenta

The RCOG has published its latest revised guidelines for health professionals caring for with pregnant women with placenta-related problems.

The guidance says early diagnosis and specialised care will help to reduce difficulties associated with complications of the placenta and ensure the safest possible outcome for mother and baby.

A detailed leaflet providing information for women who may develop these conditions has also been created.


Conditions such as placenta praevia and placenta accreta are associated with high maternal and neonatal morbidity and mortality. 

The highest rates of complication for both mother and newborn occur when these conditions are only diagnosed at birth, highlighting the need for prenatal diagnosis, according to the guidelines.

The risks of both conditions, which are often combined, increases with the numbers of previous CS. The guidelines recommend that women must be informed of this risk when discussing the benefits and risks of a caesarean birth.

Revised guidance on vasa praevia, a rare condition affecting between 1 in 1200 and 1 in 5000 pregnancies, has also been published. 

Lead author of the guidelines and consultant obstetrician and senior lecturer at University College London Professor Eric Jauniaux said: ‘We hope this updated guidance will support healthcare professionals during discussions with women and their partners who may be considering assisted reproduction, particularly IVF, or an elective caesarean birth. These are both risk factors that can increase risk of developing these serious complications of the placenta.

‘Guidelines should also help clinicians diagnose these potential complications early, and to discuss with women the safest possible ways to give birth and the advantages and disadvantages associated with each approach to ensure the best possible outcomes and to ensure personalised care.’

The new guidelines are available here and here.

The information leaflet for women is available here.