A systematic review reported that women with one, two, or three or more previous caesarean deliveries experience a 1%, 1.7% or 2.8% risk of placenta previa in a subsequent pregnancy. ( Source- Birth After Previous
Caesarean Birth Green-top Guideline No. 45 ).

Assisted reproductive technology ( RR- 3.71, OR 2.67)and maternal smoking ( OR 1.42)  increase the risk of placenta praevia.

Obstetric patients who are postoperative and receiving unfractionated heparin should have platelet count monitoring performed every  2 to3  days from days 4 to 14 or until heparin is stopped.

The platelet count should be checked after 24 hours of initiating treatment if the patient has previously received heparin (unfractionated or LMWH) in the last 100 days.

Previous vaginal delivery, particularly previous VBAC, is the single best predictor of successful VBAC and is associated with a planned VBAC success rate of 85–90%.

Previous vaginal delivery is also independently associated
with a reduced risk of uterine rupture.

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.

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.

• Measure post-void residual volume by bladder scan or catheterisation in women with symptoms suggestive of voiding dysfunction or recurrent UTI.
• Use a bladder scan in preference to catheterisation on the grounds ofacceptability and lower incidence of adverse events.
• Undertake a urine dipstick test in all women presenting with urinary incontinence.
• Undertake routine digital assessment to confirm pelvic floor muscle contraction before the use of supervised pelvic floor muscle training for the treatment of urinary incontinence.

Do not use the Q-tip, Bonney, Marshall and Fluid-Bridge tests in the assessment of women with urinary incontinence.