Conclusion

While significant progress has been made in the understanding and management of pregnancies complicated by APH, sustaining such improvements require a consistent, evidence-based approach in the management of these patients. The implementation of regular team­based obstetric haemorrhage drills is an excellent way of ensuring a system-wide improvement. Such drills should be combined with sentinel event reviews and an audit of the management of major APH. There is also an emerging role for centres of excellence for the multidisciplinary management of placenta accreta.