ABSTRACT
This chapter discusses guidance recommendations for delivery timing, the basis and limitations of such recommendations, and what is done in practice. Experts developed a consensus opinion based on available data and opinion, weighing the maternal, fetal, and neonatal risks and benefits of ongoing pregnancy versus delivery. The risk of massive hemorrhage at delivery or during pregnancy among women with previa and accreta is thought to increase with gestational age. The chapter also discusses that postpartum hemorrhage is the most frequent root cause of maternal morbidity and mortality in placenta accreta. The highest rate of delivery due to hemorrhage is reported from a survey on placenta percreta that was conducted among of members of the Society for Perinatal Obstetricians in 1995. Several groups found that shorter cervical length in placenta previa is associated with more bleeding episodes during pregnancy and with earlier delivery due to hemorrhage.
