Developing a care bundle for the management of suspected placenta accreta


Department of Obstetrics and Gynaecology, Queen Charlotte's Hospital, Imperial College NHS Healthcare Trust, Du Cane Road, London W12 OHS, UK Email:


Key content:

  • Care bundles are an established method of improving health care but they have not been used in obstetrics to date.

  • The NPSA, RCOG and RCM set up an expert group to explore whether care bundles could be a useful tool in the management of women with a low-lying placenta who have had a previous caesarean section.

  • A care bundle was designed and piloted in six obstetric units over a 5-month period and was found to be achievable in all of them.

Learning objectives:

  • To learn about the risks of morbidly adherent placenta.

  • To learn about the methods of developing a care bundle.

  • To examine the evidence for the usefulness of a care bundle for placenta praevia after previous caesarean section.

Ethical issues:

  • Once introduced to a unit, would failure to use a care bundle constitute substandard care?

  • Will the standards of care outlined in care bundles be unrealistic in some units with limited resources?

Please cite this article as: Paterson-Brown S, Singh C. Developing a care bundle for the management of suspected placenta accreta. The Obstetrician & Gynaecologist 2010;12:21–27.