Transvaginal ultrasonography was performed in 127 women thought to have placenta previa. In all cases of complete previa, placental location was confirmed at cesarean section. Where the placenta was situated in the lower segment of the uterus but did not cover the cervical os the distance from the placental edge to the internal cervical os was measured. This distance was analyzed in relation to the route of delivery. No patient with a placental edge greater than 2 cm from the internal cervical os required cesarean section for the indication of placenta previa, whereas seven of eight patients with a distance of less than or equal to 2 cm underwent cesarean section because of bleeding characteristic of a placenta previa. These preliminary results suggest that transvaginal ultrasonography measurement may indicate the optimal delivery route and make the traditional classification of placenta previa obsolete.