Use bladder diaries in the initial assessment of women with urinary
incontinence or overactive bladder.

Encourage women to complete a minimum of 3 days of the diary covering variations in their usual activities, such as both working and leisure days.

• 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.

The use of postoperative laxatives is recommended to reduce the risk of wound dehiscence.
Bulking agents should not be given routinely with laxatives.

Use of stool softeners such as lactulose is recommended for about 10 days after the repair.

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.

According to the RCOG Guideline- until blood is available, infuse up to 3.5 l of warmed clear fluids, initially 2 l of warmed isotonic crystalloid.

• Further fluid resuscitation can continue with additional isotonic
  crystalloid or colloid (succinylated gelatin).
• Hydroxyethyl starch should not be used.
•  The best equipment available should be used to achieve rapid warmed infusion of fluids

The methods that have been shown to be effective are-

1.  Epidural
2.  Combined spinal–epidural
3.  Continuous one-to-one support                                                                                                          ( Cochrane Database Syst Rev 2012;(3):CD009234)

- For pregnancies at more than 16 weeks of gestation the term low-lying placenta should be used when the placental edge is less than 20 mm from the internal os on transabdominal or transvaginal scanning (TVS).

• The term placenta praevia should be used when the placenta lies directly over the internal os.

The algorithm suggested by RCOG for low lying placenta can be accessed HERE