Criteria for referral to level 6 public hospital maternity service
- Known or suspected placenta accreta (including increta and percreta)
- Suspicion of a placenta accreta or consideration of risk factors for placenta accreta may be informed by low anterior placenta on a mid-trimester scan or known or suspected major anterior placenta praevia with a history of:
- uterine surgery including caesarean section(s) as the greater the number of uterine surgeries, the greater the likelihood of a placenta accreta
- placenta accreta
- Asherman's syndrome.
Information to be included in the referral
Information that must be provided
- Ultrasound reports
- Gestational age
- Details of any, and all previous caesarean section(s) or uterine surgery.
Provide if available
- MRI scan(s) report
- Documentation of any blood transfusion refusal.
The Summary and referral information lists the information that should be included in a referral request.
Referral to a level 6 maternity service should be considered in the context of the local maternity service system. Referring clinicians should contact the closest level 5 maternity service to discuss options.
Women with suspected or known accreta should be referred as soon as possible to ensure an appropriate management plan can be developed and put in place.
Major placenta praevia without suspicion of placenta accreta does not need to be referred.
Referral to a level 6 public maternity service is not appropriate for