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.

- For pregnancies at more than 16 weeks of gestation the term low-lying placenta should be used when the placental edge is less than 20 mm from the internal os on transabdominal or transvaginal scanning (TVS).

• The term placenta praevia should be used when the placenta lies directly over the internal os.

The algorithm suggested by RCOG for low lying placenta can be accessed HERE 

A statement from the FDA was issued following the publication of two case reports28,29 linking first trimester use of opioids to increased neural tube defects. It was concluded that the opioid use was linked to a small increase in neural tube defects, although evidence was limited and further research is needed.

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 

In the first stage of labour, pain is transmitted via
the spinal nerves of T10–L1 and results from uterine
contractions and dilatation of the cervix. In the second
stage, stretching of the pelvic ligaments causes pain via the
pudendal nerve originating from the S2–S4 nerve roots.

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.

In women with suspected PE who also have symptoms and signs of DVT, compression duplex ultrasound should be performed. If compression ultrasonography confirms the presence of DVT, no further investigation is necessary and treatment for VTE should continue.

Pregnant women with suspected PE who have symptoms and signs of DVT should have bilateral compression duplex ultrasound leg studies performed. A diagnosis of DVT may indirectly confirm a diagnosis of PE and since anticoagulant therapy is the same for both conditions, further investigation may not be necessary.

This would limit the radiation doses given to the mother and her fetus.

The algorithm suggested by the RCOG can be viewed HERE

According to NICE ( Intrapartum care for healthy
women and babies )

• Check blood pressure every 5 minutes for 15 minutes during
  establishment or after further boluses
• Check sensory block hourly
•  Continuous electronic fetal monitoring for 30 minutes during
  establishment or after boluses of 10 ml or more
• Intravenous access should be established prior to commencing regional analgesia.
• Do not administer routine preloading and maintenance fluid

A systematic review reported that women with one, two, or three or more previous caesarean deliveries experience a 1%, 1.7% or 2.8% risk of placenta previa in a subsequent pregnancy. ( Source- Birth After Previous
Caesarean Birth Green-top Guideline No. 45 ).

Assisted reproductive technology ( RR- 3.71, OR 2.67)and maternal smoking ( OR 1.42)  increase the risk of placenta praevia.