Non-hormonal contraceptive methods are recommended.

According to UKMEC- For women with 'Current breast cancer' , Cu IUCD is Category 1 , all other contraceptive methods are category 4.

For women with 'Past' breast cancer' , Cu IUCD is Category 1 , all other contraceptive methods are category 3.

Checking the environment is THE FIRST STEP. Who knows the patient has been electrocuted from a faulty electric wire ! Touching her without assessing the environment can harm the healthcare provider.

In clinically suspected DVT or PE, treatment with low-molecular-weight heparin (LMWH) should be commenced immediately until the diagnosis is excluded by objective testing, unless treatment is strongly contraindicated.

Compression duplex ultrasound should be undertaken where there is clinical suspicion of DVT.
If ultrasound is negative and there is a low level of clinical suspicion, anticoagulant treatment can be discontinued.

If ultrasound is negative and a high level of clinical suspicion exists, anticoagulant
treatment should be discontinued but the ultrasound should be repeated on days 3 and 7.

Intravenous unfractionated heparin is the preferred, initial treatment in massive PE with cardiovascular compromise.

Methotrexate adjuvant therapy should not be used for expectant management as it is of unproven benefit and has significant adverse effects.

• 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.

• If pharmacological measures fail to control the haemorrhage, surgical interventions should be initiated sooner rather than later.
• Intrauterine balloon tamponade is an appropriate first-line ‘surgical’ intervention for most women where uterine atony is the only or main cause of haemorrhage.

With Remifentanyl PCA- Respiratory depression is reported in up to 32% of patients and
oxygen saturations below 90% are seen in about 5%.

Some suggested contraindications of Remifentanyl PCA include- morbid obesity, clinical features of a chest infection and primigravida women who are at risk of prolonged labour.