Risk of anal sphincter injury in women undergoing VBAC is 5%.

Birthweight is the strongest predictor of anal sphincter injury in women undergoing VBAC.

It should be done at 32–34 weeks of gestation for women with twins.

The recommended time of testing is 3–5 weeks prior to the anticipated delivery date- therefore  35–37 weeks of gestation in singleton pregnancies with no risk factors for preterm delivery.

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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Successful VBAC is more likely among women with previous caesarean for
fetal malpresentation (84%) compared with women with previous caesarean for either labour dystocia (64%) or fetal distress (73%) indications.

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

Women are generally advised to wait for at least 2 years after treatment for breast cancer before
conception.

• 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.

• Anthracyline regimens are safe
• There are fewer data on taxanes, which should be reserved for high-risk (node-positive) or metastatic disease.
• Tamoxifen is not used until after delivery.
• Trastuzumab  is contraindicated during pregnancy.
• Haemopoietic growth factors (granulocyte colony stimulating factor) may be employed to ameliorate chemotherapy-induced neutropenia.

Cord presentation is the presence of the umbilical cord between the fetal presenting part and the cervix, with or without intact membranes. ( i.e if the cord  is present ABOVE the cervix, with ruptured membranes- this is cord PRESENTATION)

Cord prolapse is descent of the umbilical cord through the cervix  in the presence of ruptured membranes.

Cord prolapse can be occult ( Alongside the presenting part) or OVERT (Past the presenting part)

GBS is present in the bowel flora of 20–40% of adults (this is called ‘colonisation’). People who are colonised are called
‘carriers’. This includes pregnant women (there is no evidence that its carriage rate is specifically affected by pregnancy).

• IAP( Intrapartum antibiotic prophylaxis)  is recommended for women in confirmed preterm labour.  The risk of GBS infection is higher with preterm delivery and the mortality rate from infection is increased (20–30% versus 2–3% at term). For this reason, IAP is recommended for women in confirmed preterm labour.
• There is no evidence that intrapartum vaginal cleansing will reduce the risk of neonatal GBS disease.
• Polymerase chain reaction or other near-patient testing at the onset of labour is not recommended.

Read about Intrapartum Care in VBAC-

https://obgresource.com/2021/12/10/intrapartum-care-in-vbac-2/

Conception during tamoxifen therapy should be avoided because
of potential teratogenicity, and a ‘washout period’ of 2–3 months is advised