Up to 10% of women scheduled for ERCS go into labour before
39+0 weeks. Therefore it is good practice to to discuss and document a plan for delivery if labour starts prior to the scheduled date.

The contraindications/Cautions are-

• Known bleeding disorder (e.g. haemophilia, von Willebrand’s disease or acquired coagulopathy)
• Active antenatal or postpartum bleeding
  - Women considered at increased risk of major haemorrhage (e.g. placenta praevia)
  - Thrombocytopenia (platelet count < 75 × 109/l)
  - Acute stroke in previous 4 weeks (haemorrhagic or ischaemic)
  - Severe renal disease (glomerular filtration rate [GFR] < 30 ml/minute/1.73m2)
  - Severe liver disease (prothrombin time above normal range or known varices)
  - Uncontrolled hypertension (blood pressure > 200 mmHg systolic or > 120 mmHg diastolic)
•  ( In case of any doubt, a haematologist review should be sought)

Do not use pad tests in the routine assessment of women with urinary
incontinence.

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.

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.

Pregnant women with red cell antibodies, who are assessed as being at high risk of requiring a blood transfusion, should have a cross-match sample taken at least every week.

Current BCSH guidelines require a sample no more than 72 hours old for providing compatible blood in
pregnancy,but do allow a deviation to the 3-day rule for individual cases such as high-risk women with placenta praevia without red cell antibodies where weekly samples can be taken, as long as a risk assessment is made and recorded in each individual case

In high-risk women with red cell antibodies where a sample every 72 hours is not feasible, a sample should be taken once a week and if transfusion is required a new sample should be taken immediately, to exclude new antibody development. However, in the event of life threatening haemorrhage, urgent transfusion should not be delayed and close liaison with the hospital transfusion laboratory is vital.

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

CTPA delivers a low radiation dose to the fetus