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.

NSAIDs can lead to neonatal pulmonary hypertension and premature closure of the ductus arteriosus.

NSAIDs also reduce fetal renal blood flow and thus urine production leading to a reduced amniotic fluid volume.

The use of NSAIDs should, therefore, be avoided at more than 30 weeks of gestation.

• LMWHs are the agents of choice for antenatal and postnatal thromboprophylaxis.
  - Doses of LMWH are based on weight.
• For thromboprophylaxis the booking or most recent weight
  can be used to guide dosing

Read about Intrapartum Care in VBAC-

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

Cryoprecipitate should be used for fibrinogen replacement.

Fibrinogen loss can be replaced by cryoprecipitate or fibrinogen concentrate .

But fibrinogen concentrate is not licensed for acquired hypofibrinogenaemia in the UK.

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.