Procedure in LabourFollowing the diagnosis of labour:• Insert a large bore venflon.• Send blood for FBC & group and save.• Review by Specialist registrar to confirm that trial of scar is still appropriate. A plan of management should be agreed and written in the woman’s notes.• Commence continuous CTG monitoring. Abnormal fetal heart rate patterns are present in 70% scar ruptures.• Take the maternal pulse regularly (½hrly) as a rising pulse rate may provide early indication of scar rupture.• All methods of analgesia are available to these women including an epidural.• If a woman with an effective epidural complains of pain, she should be examined carefully to exclude rupture of the uterus. In this situation, pain arises from generalised peritoneal irritation.• There should be no delay in performing an ARM if there is slow progress in labour or concerns about the CTG. This enables examination of the liquor for meconium or blood and, to some extent, augmentation of labour.• A woman admitted with contractions, with a uterine scar, who is not diagnosed as in labour by the midwife should be reviewed by the obstetric SpR. She should have her case discussed with the on-call consultant.