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

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.

Caesarean section is the recommended mode of delivery in cases of cord prolapse when vaginal birth is not imminent in order to prevent hypoxic acidosis.
Category 2 caesarean birth can be considered for women in whom the fetal heart rate pattern is normal, but continuous assessment of the fetal heart trace is essential.

In case of cord prolapse in advanced labor , delivery should be expedited.

A document on categories of Caesarean section can be found here-CLICK HERE

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

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).

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.

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

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

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

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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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)