Previous vaginal delivery, particularly previous VBAC, is the single best predictor of successful VBAC and is associated with a planned VBAC success rate of 85–90%.

Previous vaginal delivery is also independently associated
with a reduced risk of uterine rupture.

According to the RCOG Guidance, it is 39%

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.

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 contraindications/Cautions are-

• Known bleeding disorder (e.g. haemophilia, von Willebrand’s disease or acquired coagulopathy)
• Active antenatal or postpartum bleeding
  - Women considered at increased risk of major haemorrhage (e.g. placenta praevia)
  - Thrombocytopenia (platelet count < 75 × 109/l)
  - Acute stroke in previous 4 weeks (haemorrhagic or ischaemic)
  - Severe renal disease (glomerular filtration rate [GFR] < 30 ml/minute/1.73m2)
  - Severe liver disease (prothrombin time above normal range or known varices)
  - Uncontrolled hypertension (blood pressure > 200 mmHg systolic or > 120 mmHg diastolic)
•  ( In case of any doubt, a haematologist review should be sought)

Treatment with therapeutic doses of subcutaneous LMWH should be employed during the remainder of the pregnancy and for at least 6 weeks postnatally and until at least 3 months of treatment has been given in total.

Use bladder diaries in the initial assessment of women with urinary
incontinence or overactive bladder.

Encourage women to complete a minimum of 3 days of the diary covering variations in their usual activities, such as both working and leisure days.

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

ABG Analysis is of limited value in diagnosis of PE.

In one study- ABG analysis showed that only 10% had arterial P O2 levels less than 60 mmHg and 2.9% had oxygen saturation levels less than 90%.