What are the recommended follow-up protocols for a patient diagnosed with a low-lying placenta at the 20-week scan?

A patient diagnosed with a low-lying placenta at the 20-week ultrasound scan should have a follow-up ultrasound scan around 28 weeks, but no later than 29 weeks, to reassess placental location and exclude placenta accreta, performed by a senior clinician with expertise in placental assessment. If placenta accreta is suspected, referral to a specialist placenta accreta spectrum centre is recommended for further care and management. Discussions about birth options, including timing and mode of delivery, should be conducted by a senior obstetrician. The multidisciplinary team should plan the delivery, ensuring appropriate specialists and resources are available if a caesarean birth is indicated. Routine antenatal care should continue, including monitoring for complications such as pre-eclampsia and fetal growth restriction, with additional scans or interventions as clinically indicated. The woman should be advised to report any concerns about bleeding or fetal movements promptly to maternity services.