• Warfarin use in pregnancy is restricted to the few situations where heparin is considered unsuitable,e.g. some women with mechanical heart valves.
• Women with previous VTE associated with antithrombin deficiency (who will often be on long-term
  oral anticoagulation) should be offered thromboprophylaxis with higher dose LMWH (either 50%,
  75% or full treatment dose)
• Danaparoid is a heparinoid that is mostly used in patients intolerant of heparin, either because of HIT or a skin allergy to heparins

According to NICE ( Intrapartum care for healthy
women and babies )

• Check blood pressure every 5 minutes for 15 minutes during
  establishment or after further boluses
• Check sensory block hourly
•  Continuous electronic fetal monitoring for 30 minutes during
  establishment or after boluses of 10 ml or more
• Intravenous access should be established prior to commencing regional analgesia.
• Do not administer routine preloading and maintenance fluid

• 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.

Read about Intrapartum Care in VBAC-

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

Advise women with urinary incontinence or overactive bladder who have a BMI greater than 30 to lose weight.

Offer a trial of supervised pelvic floor muscle training of at least 3 months'
duration as first-line treatment to women with stress or mixed urinary
incontinence.Pelvic floor muscle training programmes should comprise at least 8 contractions performed 3 times per day.

Do not use perineometry or pelvic floor electromyography as biofeedback as a routine part of pelvic floor muscle training.

• People who experience fertility problems should be offered counselling because
  fertility problems themselves, and the investigation and treatment of fertility
  problems, can cause psychological stress.
• Counselling should be offered before, during and after investigation and
  treatment, irrespective of the outcome of these procedures.
• Counselling should be provided by someone who is not directly involved in the
  management of the individual's and/or couple's fertility problems.

• Offer bladder training lasting for a minimum of 6 weeks as first-line treatment to women with urgency or mixed urinary incontinence.
• If women do not achieve satisfactory benefit from bladder training programmes, the combination of an overactive bladder medicine with bladder training should be considered if frequency is a troublesome symptom.
• Offer a face-to-face or telephone review 4 weeks after starting a new medicine for overactive bladder

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

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

Active management of Third stage of Labor includes -

1. Administer 10 IU of oxytocin by intramuscular injection with the birth of the anterior shoulder or immediately after the birth of the baby and before the cord is clamped and cut.

2. After administering oxytocin, clamp and cut the cord- Do not clamp the cord earlier than 1 minute from the birth of the baby unless there is concern about integrity of the cord, or well being of the baby ( e.g heart rate below 60 bpm AND not getting faster) .
Clamp the cord before 5 minutes.

3. After cutting the cord, use controlled cord traction- only after administration of oxytocin and signs of separation of the placenta.