The Placenta Praevia after Caesarean Section (PPCS) Care Bundle is a tool to support safer clinical practice in maternity units. This aims to reduce harm associated with placenta praevia in women who have had one or more previous caesarean sections. The care bundle has been put together following a review of evidence and expert consensus.
All women undergoing caesarean section at high risk of placenta accreta should be managed in line with this care bundle. This will include:
Women with one or more previous caesarean section and placenta praevia.
Women with a previous scar where imaging of placental localisation has found the placenta to be lying over the previous scar, even if it is well clear of the internal cervical os.
The elements of the care bundle are:
Consultant obstetrician planned and directly supervising delivery.
Consultant obstetric anaesthetist planned and directly supervising anaesthesia at delivery.
Blood and blood products available on-site.
Multidisciplinary involvement in pre-operative planning.
Discussion and consent includes possible interventions (such as hysterectomy, leaving placenta in situ, cell salvage and interventional radiology).
Local availability of level 2 critical care bed.
On 15 July, Professor James Walker (NPSA Clinical Advisor, Obstetrics) and Sara Johnson (Head of Patient Safety, Child Health and Maternity Care) presented a webinar to discuss the PPCS Care Bundle.
Listen to the webinar:
Placenta Praevia after Caesarean Section Care Bundle Recording
This webinar recording is of interest to obstetricians, midwives, maternity service managers, trust executives, risk managers and other health care professionals involved in the care of women undergoing caesarean section at high risk of placenta accreta.