Diagnosis and Management of Placenta Previa

Objective: To review the use of transvaginal ultrasound for the diagnosis of placenta previa and recommend management based on accurate placental localization. Options: Transvaginal sonography (TVS) versus transabdominal sonography for the diagnosis of placenta previa; route of delivery, based on placenta edge to internal cervical os distance; in-patient versus out-patient antenatal care; cerclage to prevent bleeding; regional versus general anaesthesia; prenatal diagnosis of placenta accreta. Outcome: Proven clinical benefit in the use of TVS for diagnosing and planning management of placenta previa. Evidence: MEDLINE search for "placenta previa" and bibliographic review. Benefits, Harms, and Costs: Accurate diagnosis of placenta previa may reduce hospital stays and unnecessary interventions.