Obstetrics often goes hand in hand with bleeding. Obstetricians often refer to their profession as a bloody business. This is because maternal mortality due to obstetric hemorrhage remains high, even though medical advances continue. Anterior placenta is the leading cause of late pregnancy bleeding and is one of the most common clinical emergencies. Risk factors for anterior placenta include miscarriage, evacuation, history of cesarean section, multiple pregnancies, and smoking. Its occurrence has been gradually increasing in recent years. If a pregnant woman has had a cesarean section and the placenta is located in the scar of the previous operation, this type of placenta praevia is more complicated, often accompanied by placental implantation, more serious postpartum bleeding, and a significantly higher rate of hysterectomy. The Department of Obstetrics and Gynecology of our hospital has recently treated a large number of cases of fatal placenta praevia, and has accumulated rich experience in this area. Among them, Professor Zou Li took the lead in writing and publishing the national clinical diagnosis and management guidelines of placenta praevia. The guidelines clarify several points of diagnosis and management of placenta praevia, which are in line with the international guidelines and combined with the clinical practice in China. In the past 3 months alone, our department has handled 19 cases of complete placenta praevia, among which 5 cases were of the aggressive type and 3 cases were hysterectomized. After comprehensive preoperative diagnosis and perfect preparation, each patient was delivered by cesarean section at the right time and hysterectomy was performed at the same time with good prognosis. The key points for successful treatment of such patients are: adequate preoperative evaluation; selection of the appropriate timing for termination of pregnancy; and development of a reasonable surgical plan. We should scientifically predict the risk of vaginal hemorrhage in the short term according to the guidelines and recommend well-prepared elective surgical termination of pregnancy, which has a far better prognosis than emergency surgery without adequate preparation. Pre-operative preparation of adequate homogeneous red blood cells and blood products is required to prevent intra-operative and post-operative hemorrhagic shock that could endanger the life of mother and child. Preoperative ultrasound should be used to determine the position and orientation of the placenta, which provides a basis for the surgical approach to facilitate smooth delivery of the fetus and to prevent intraoperative bleeding and shock. The use of MRI to understand the placenta position, placental adhesions implantation, uterus-bladder relationship, and full understanding of the condition is helpful for comprehensive preparation. Improper selection of the uterine incision during surgery can make delivery and management difficult. Mothers with anterior placenta have poorly formed lower uterine segment, thick uterine muscle, no stretching, high intrauterine pressure accompanied by contraction of the uterus, and immature babies have poor tolerance to stimulation such as pressure, so they will encounter many problems during surgery such as high bleeding and difficulty in delivery of the fetus. The surgical incision should be chosen flexibly according to the site of placental attachment, and the decision to preserve the uterus should be made depending on the intraoperative situation. The uterus should be removed decisively for large placenta area, thin uterine wall, poor contraction, and heavy bleeding in a short period of time to avoid indecisiveness and poor prognosis of the patient. For patients with little intraoperative bleeding and small implantation area, the uterus can be preserved. Use sutures and compression to stop bleeding. Postoperatively, anti-inflammatory and uterine contractions are intensified, and vaginal bleeding and infection are monitored. It is the responsibility of obstetricians to successfully treat the aggressive placenta praevia, but we are deeply aware that prevention is more important than cure. We should pay more attention to education, promote healthy living, pay attention to contraception, reduce uterine operations; choose the reasonable way to terminate pregnancy and reduce the rate of unindicated cesarean delivery. Pay attention to perinatal health care and strengthen prenatal checkups. Reduce the occurrence of placenta praevia, reduce maternal and fetal infant morbidity and mortality.