Systemic chemotherapy is contraindicated in the first trimester because of a high rate of fetal
abnormality,but is safe from the second trimester.

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

Use of UFH predisposes patients to thrombocytopenia..

Obstetric patients who are postoperative and receiving unfractionated heparin should have platelet count monitoring performed from days 4 to 14 ,

or until heparin is stopped.

Obstetric patients who are postoperative and receiving unfractionated heparin should have platelet count monitoring performed every  2 to3  days from days 4 to 14 or until heparin is stopped.

The platelet count should be checked after 24 hours of initiating treatment if the patient has previously received heparin (unfractionated or LMWH) in the last 100 days.

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.

Successful VBAC is more likely among women with previous caesarean for
fetal malpresentation (84%) compared with women with previous caesarean for either labour dystocia (64%) or fetal distress (73%) indications.

• LMWHs are the agents of choice for antenatal and postnatal thromboprophylaxis.
  - Doses of LMWH are based on weight.
• For thromboprophylaxis the booking or most recent weight
  can be used to guide dosing

• Anthracyline regimens are safe
• There are fewer data on taxanes, which should be reserved for high-risk (node-positive) or metastatic disease.
• Tamoxifen is not used until after delivery.
• Trastuzumab  is contraindicated during pregnancy.
• Haemopoietic growth factors (granulocyte colony stimulating factor) may be employed to ameliorate chemotherapy-induced neutropenia.