CONCLUSION
There are only a few differences in regards to intra-operative
management and post-operative complications, none of which pose serious
maternal morbidity. Therefore our findings further strengthen the RCOG
recommendations of an individualised approach towards managing placenta
praevia with any bleeding episode. We advise taking into account
patients’ wishes, their ability to access emergency services and the
availability of transportation. Hence, our findings suggest that it may
be reasonable to continue safely managing women with placenta praevia
and previous bleeding episodes in the outpatient setting.
Further large-scale, multicentre prospective studies using a single
validated method of data collection is encouraged to provide a more
accurate representation of maternal outcomes directly linked to placenta
praevia. In order to optimise maternal outcomes in placenta praevia
further research ought to focus on the aetiology of APH and formulate
strategies for the prevention and treatment of bleeding.