The correct answer is- 11 g/ 100 ml at first contact and 10.5 g/100 ml at 28 weeks.

Haemoglobin outside this range should be investigated and iron supplementation considered if indicated.

Pregnant women should be offered screening for anaemia. Screening should
take place early in pregnancy (at the booking appointment) and at 28 weeks
when other blood screening tests are being performed. This allows enough time
for treatment if anaemia is detected.

Source- 1. NICE  Antenatal care for uncomplicated
pregnancies
Clinical guideline
Published: 26 March 2008

2. RCOG Green-top Guideline No. 52

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.

Planned VBAC is contraindicated in women with previous uterine rupture or classical caesarean scar.

Women who have had two or more prior lower segment caesarean deliveries may be offered VBAC after counselling by a senior obstetrician. This should include the risk of uterine rupture and maternal morbidity, and the individual likelihood of successful VBAC.

CTPA is associated with relatively high radiation dose (up to 20 mGy) to the mother’s breast tissue, which is associated with an increased risk of breast cancer.

The dose estimate for CTPA is 20 to 100 times greater.
than for V/Q scanning

• 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.