Incidence and Risk Factors for Severe Postpartum Hemorrhage in Women With Anterior Low-Lying or Previa Placenta and Prior Cesarean: Prospective Population-Based Study

( BJOG . 2023;130(13):1653–1661. doi: 10.1111/1471-0528.17554) The presence of an abnormally located placenta (either anterior low lying or previa) along with a history of prior cesarean section is associated with placenta accreta spectrum (PAS). Diagnostic tests for PAS are recommended for patients with this combination of risk factors to provide care at specialized, high resource institutions and limit maternal morbidity and mortality. Recommendations for referral to specialized centers in the setting of prior cesarean delivery and either anterior low lying or placenta previa vary due to lack of evidence in this group of patients. This population-based cohort study seeks to understand whether the incidence and risk factors for severe PPH can be found in women with an abnormally located placenta as well as a prior cesarean section in the absence of a prenatal PAS diagnosis.