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

Planned VBAC is contraindicated in women with previous uterine rupture or classical caesarean scar.

Women who have had two or more prior lower segment caesarean deliveries may be offered VBAC after counselling by a senior obstetrician. This should include the risk of uterine rupture and maternal morbidity, and the individual likelihood of successful VBAC.

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

Non-hormonal contraceptive methods are recommended.

According to UKMEC- For women with 'Current breast cancer' , Cu IUCD is Category 1 , all other contraceptive methods are category 4.

For women with 'Past' breast cancer' , Cu IUCD is Category 1 , all other contraceptive methods are category 3.

The six elements considered to be reflective of good care are:
 Consultant obstetrician planning and directly supervising delivery.
 Consultant anaesthetist planning and directly supervising anaesthesia at delivery.
 Blood and blood products available.
 Multidisciplinary involvement in preoperative planning.
 Discussion and consent, including possible interventions (such as hysterectomy, leaving the placenta in situ, cell
salvage and interventional radiology).
 Local availability of a level 2 critical care bed.

According to the RCOG- Any lack of compliance with the care bundle by the clinical team for a woman with either placenta praevia or accreta
should be investigated.

According to MBBRACE-UK 2014 to 2016- Women who have had a previous caesarean section who also have either placenta praevia or an anterior placenta underlying the old caesarean section scar at 32 weeks of gestation are at increased risk of placenta accreta and should be managed as if they have placenta accreta, with appropriate preparations for surgery made.

The likelihood of maternal GBS carriage in this pregnancy is 50%.
What should be done?- Discuss the options- a. Intrapartum antibiotic prophylaxis ( IAP).
b. Bacteriological testing in late pregnancy and the offer of IAP if still positive. ( This is the only group of women who are eligible for GBS screening funded by NHS)

Antenatal treatment for vaginal or rectal colonisation does not reduce the likelihood of GBS colonisation at the time of delivery and so is not indicated in this situation.

IAP should be offered to GBS-colonised women

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

In pregnancies<12 weeks gestation, anti-D Ig prophylaxis is only indicated following ectopic pregnancy, molar pregnancy, therapeutic termination of pregnancy and in
cases of uterine bleeding where this is repeated, heavy
or associated with abdominal pain. The minimum dose should be 250 IU. A test for fetomaternal haemorrhage (FMH) is not required

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.

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

The UK National Screening Committee examined the issue of strategies recommended that routine screening using bacteriological culture or near-patient testing techniques should not be introduced into UK practice.

The US Guidelines advise that all pregnant women should be offered screening for GBS carriage at 35–37 weeks of gestation and those found to be colonised with GBS should be offered intrapartum antibiotic prophylaxis.

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).