Aim:  This study was undertaken to determine if the need for red cell blood transfusion in placenta praevia could be predicted.
Methods:  Data from a retrospective observational study of 246 obstetric patients, with placenta praevia, from 1999 to 2005 were analysed to generate a model to predict requirement for transfusion.
Results:  Seventy‐one patients were transfused. Independent risk factors for transfusion were gestational age at delivery of 32–35 weeks [odds ratio (OR): 2.6; 95% confidence interval (CI): 1.1–6.4] and caesarean combined with hysterectomy (OR: 29.4; 95% CI: 5.9–145.9; P < 0.001). No independent risk of transfusion was associated with maternal age, race, parity, smoking status, type of anaesthesia, caesarean combined with arterial balloon occlusion, grade of placenta, accreta and previous uterine surgery. Conclusions:  Gestational age at delivery and type of surgery required are predictors of transfusion during caesarean for placenta praevia. Arterial balloon occlusion does not appear to increase transfusion risk and may be considered as one of the techniques in management.