The RAADP scheme should be regarded as supplementary to any anti-D Ig administered for sensitising episodes.

It is not necessary to administer anti-D Ig to D negative females without childbearing potential, or males who receive D positive platelets.

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Systemic chemotherapy is contraindicated in the first trimester because of a high rate of fetal
abnormality,but is safe from the second trimester.

After collection, swabs should be placed in a non-nutrient transport medium, such as Amies or Stuart. Specimens should be transported and processed as soon as possible. If processing is delayed, specimens should be refrigerated. When testing for GBS, the lab should be specifically informed that the swab is for GBS testing.

Planned VBAC is associated with an approximately 1 in 200 (0.5%)
risk of uterine rupture

When testing for GBS carrier status, a swab should be taken from the lower vagina and the anorectum.

A single swab (vagina then anorectum) or two different swabs can be used.

In the event of an intrauterine death (IUD), where no sample can be obtained from the baby, an appropriate dose of prophylactic anti-D Ig should be administered within
72 h of the diagnosis of IUD, irrespective of the time of subsequent delivery.

• The timing of delivery should be tailored to the patient.
• If history of vaginal bleeding/ other risk factors for preterm delivery- consider ‘Late preterm delivery’- 34+0 to 36 +6 weeks.
• If uncomplicated placenta previa- Consider between 36+ 0 and 37+0.

If the placenta is thought to be low lying (less than 20 mm from the internal os) or praevia
(covering the os) at the routine fetal anomaly scan, a follow-up ultrasound examination
including a TVS is recommended at 32 weeks of gestation to diagnose persistent low-lying
placenta and/or placenta praevia.

Use of TVS- to accurately see the placental edge. Also, cervical length is a predictor of antepartum bleeding and emergency preterm caesarean section in placenta praevia. Women with a cervical length of less than 31 mm have a 16 times higher risk of emergency
caesarean section due to massive haemorrhage.

Routine ultrasound screening is not useful. Selective ultrasound screening can be considered for women with breech presentation at term who are considering vaginal birth.

Up to 10% of women scheduled for ERCS go into labour before
39+0 weeks. Therefore it is good practice to to discuss and document a plan for delivery if labour starts prior to the scheduled date.

- For pregnancies at more than 16 weeks of gestation the term low-lying placenta should be used when the placental edge is less than 20 mm from the internal os on transabdominal or transvaginal scanning (TVS).

• The term placenta praevia should be used when the placenta lies directly over the internal os.

The algorithm suggested by RCOG for low lying placenta can be accessed HERE 

The recommended dose is - 3 g intravenous benzylpenicillin be given as soon as possible after the onset of labour  and 1.5 g 4 hourly until delivery.
The first dose should be given at least 4 hours prior to delivery.