- 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 

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.

In the first stage of labour, pain is transmitted via
the spinal nerves of T10–L1 and results from uterine
contractions and dilatation of the cervix. In the second
stage, stretching of the pelvic ligaments causes pain via the
pudendal nerve originating from the S2–S4 nerve roots.

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

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.

In women at very high risk of thrombosis , UFH may be used peripartum in
preference to LMWH where there is an increased risk of haemorrhage or where regional anaesthetic techniques may be required.

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