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)

This is GBS bacteruria. GBS bacteriuria is associated with a higher risk of chorioamnionitis and neonatal disease. Women with GBS bacteriuria should be offered IAP.

Women with GBS urinary tract infection (growth of greater than 10^5 cfu/ml) during pregnancy should receive appropriate treatment at the time of diagnosis as well as IAP. 

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

A dose of 250 IU anti-D immunoglobulin should be sufficient to cover up to five adult therapeutic doses of D positive platelets given within a 6-week period.

In severely thrombocytopenic patients with platelet count of?30 × 10^9/L, anti-D Ig should be given subcutaneously, or IV.

Bonus info- There is at least one more condition in which the delivery should be delayed for some time after appearance of the condition- Chickenpox ! In varicella rash- planned delivery should normally be avoided for at least 7 days after the onset of the maternal rash to allow for the passive transfer of antibodies from mother to child.

Methotrexate adjuvant therapy should not be used for expectant management as it is of unproven benefit and has significant adverse effects.

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

A systematic review reported that women with one, two, or three or more previous caesarean deliveries experience a 1%, 1.7% or 2.8% risk of placenta previa in a subsequent pregnancy. ( Source- Birth After Previous
Caesarean Birth Green-top Guideline No. 45 ).

Assisted reproductive technology ( RR- 3.71, OR 2.67)and maternal smoking ( OR 1.42)  increase the risk of placenta praevia.

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.

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 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.

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.

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.

• 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.