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Abnormal Placentation: Evidence-Based Diagnosis and Management of Placenta Previa, Placenta Accreta, and Vasa Previa

Rao, Kiran Prabhaker MD*; Belogolovkin, Victoria MD; Yankowitz, Jerome MD; Spinnato, Joseph A. II MD§

Obstetrical & Gynecological Survey: August 2012 - Volume 67 - Issue 8 - p 503–519
doi: 10.1097/OGX.0b013e3182685870

Placenta previa, placenta accreta, and vasa previa cause significant maternal and perinatal morbidity and mortality. With the increasing incidence of both cesarean delivery and pregnancies using assisted reproductive technology, these 3 conditions are becoming more common. Advances in grayscale and Doppler ultrasound have facilitated prenatal diagnosis of abnormal placentation to allow the development of multidisciplinary management plans to achieve the best outcomes for mother and baby. We present a comprehensive review of the literature on abnormal placentation including an evidence-based approach to diagnosis and management.

Targeted Audience: Obstetricians & Gynecologists, Family Physicians.

Learning Objectives: After completing this CME activity, physicians should be better able to: assess risk factors associated with placenta previa, placenta accreta, and vasa previa; evaluate sonographic characteristics of placenta previa, placenta accreta, and vasa previa; formulate antepartum management plans and delivery plans for patients with placenta previa, placenta accreta, and vasa previa; implement preoperative planning and surgical techniques used in management of placenta previa, placenta accreta, and vasa previa; and categorize the risks and benefits associated with conservative management of placenta accreta.

*3rd Year Fellow, †Assistant Professor, ‡Professor and Chairman, and §Professor, Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of South Florida Morsani College of Medicine, Tampa, FL.

All faculty and staff in a position to control the content of this CME activity and their spouses/life partners (if any) have disclosed that they have no financial relationships with, or financial interests in, any commercial organizations related to this CME activity.

Correspondence requests to: Kiran Rao, MD, Florida Perinatal Associates, Obstetrix Medical Group, 13601 Bruce B. Downs Blvd, Suite 250, Tampa, FL 33613. E-mail:

© 2012 Lippincott Williams & Wilkins, Inc.