• Warfarin use in pregnancy is restricted to the few situations where heparin is considered unsuitable,e.g. some women with mechanical heart valves.
• Women with previous VTE associated with antithrombin deficiency (who will often be on long-term
  oral anticoagulation) should be offered thromboprophylaxis with higher dose LMWH (either 50%,
  75% or full treatment dose)
• Danaparoid is a heparinoid that is mostly used in patients intolerant of heparin, either because of HIT or a skin allergy to heparins

;WD,W

Pregnant women with red cell antibodies, who are assessed as being at high risk of requiring a blood transfusion, should have a cross-match sample taken at least every week.

Current BCSH guidelines require a sample no more than 72 hours old for providing compatible blood in
pregnancy,but do allow a deviation to the 3-day rule for individual cases such as high-risk women with placenta praevia without red cell antibodies where weekly samples can be taken, as long as a risk assessment is made and recorded in each individual case

In high-risk women with red cell antibodies where a sample every 72 hours is not feasible, a sample should be taken once a week and if transfusion is required a new sample should be taken immediately, to exclude new antibody development. However, in the event of life threatening haemorrhage, urgent transfusion should not be delayed and close liaison with the hospital transfusion laboratory is vital.

There are no firm criteria for initiating red cell transfusion. The decision to provide blood transfusion should be based on both clinical and haematological assessment.

The 2009–12 Confidential Enquiries into Maternal Deaths and Morbidity report3 highlighted the importance
of correlating clinical signs and symptoms expected from different blood loss values to help target decisions on resuscitation, and also emphasised the importance of taking the woman’s weight into account.

The therapeutic target in case of massive blood loss is to maintain Haemoglobin  greater than 8 gm/dL.

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.