If accidental dural puncture occurs with an epidural needle there is a 70–80% chance of a postdural puncture headache

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

Antenatal thromboprophylaxis for those with previous VTE should begin as early in pregnancy as practical.

Women with previous VTE should be offered prepregnancy counselling, and a  prospective management plan for thromboprophylaxis in pregnancy should be made. Those who become pregnant beforemreceiving such counselling should be referred at the earliest opportunity in pregnancy to a clinician
with expertise in thrombosis in pregnancy.

Well done for taking the quiz ! Small steps taken everyday make a huge difference.

1. Women presenting with symptoms and signs of an acute PE should have an electrocardiogram (ECG) and a chest X-ray (CXR) performed.
2. The algorithm suggested in the Green Top Guideline can be viewed HERE 

If non-surgical management for stress urinary incontinence has failed, and the woman wishes to think about a surgical procedure, offer her the choice of:
- colposuspension (open or laparoscopic) or
- an autologous rectus fascial sling.

After undertaking a detailed clinical history and examination, perform
multichannel filling and voiding cystometry before surgery for stress urinary
incontinence in women who have anterior or apical prolapse.

Before surgery- an MDT should review the proposed treatment. And before surgery, women should be asked for consent for their data to be entered in a national registry.

Codeine is converted to active metabolites, mainly morphine. The ultrarapid metaboliser phenotype is due to duplications of the CYP2D6 gene, and prevalence varies by ethnic origin.

Ultrarapid metabolisers who take codeine can have up to 50% higher plasma concentrations
of its active metabolite morphine than extensive metabolisers, with the consequence that there is a risk of serious toxicity even at therapeutic doses of codeine in such individuals.