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Placenta Praevia Preparation — FRCA Final MCQ

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ModerateObstetric AnaesthesiaPlacenta Praevia PreparationFRCA Final

A 38-year-old woman (ASA II, 70 kg) at 34 weeks gestation with known placenta praevia major (placenta completely covering the internal os) is admitted with a small antepartum haemorrhage. She is stable. What preparation should the anaesthetist make?

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Correct answer: A — Ensure 4 units of crossmatched blood are available and large-bore IV access is sited

Placenta praevia major carries a high risk of massive haemorrhage at any time. Proactive preparation includes: large-bore IV access (14-16G, ideally two), crossmatch 4 units of packed red cells available, group and screen with full blood count and coagulation baseline, cell salvage equipment available, senior anaesthetist and obstetrician notified, and plan for anaesthetic technique documented. Surgery is not indicated unless bleeding is uncontrollable or the patient reaches 36-37 weeks for elective delivery.

Reference: RCOG – 2018 – GTG 27a Placenta praevia and accreta; OAA – 2024 – QRH: Major obstetric haemorrhage