Screening

Normal pregnancy

Screening for PP is not indicated in this population, even if other risk factors are present (with the exception of previous scarred uterus, prior PP, and IVF treatment). Prediction models combining risk factors for PP are too inefficient to be useful.[9]

Previously scarred uterus

Screening by ultrasound with referral for colour flow Doppler ultrasound if PP is suspected.[2][3][4] The radiologist should be informed about the risk of placenta accreta spectrum.[4] Advice should be sought from the ultrasonographer or consultant obstetrician as to whether or not an MRI is indicated.[6][9][10][24][31][32]

Prior placenta praevia

PP has a moderate risk of recurrence (about 0.7%).[13] Careful attention should be paid to the position of the placenta in subsequent pregnancies; ultrasound should be obtained mid second trimester.

In vitro fertilisation (IVF)

Pregnancies resulting from IVF have about a 2% risk of PP.[33][34][35]

Screening by ultrasound, at about 18 to 22 weeks' gestation, is indicated.[33][34][35]

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