People who are concerned about their fertility should be informed that over
80% of couples in the general population will conceive within 1 year if:
- the woman is aged under 40 years and
- they do not use contraception and have regular sexual intercourse.
Of those who do not conceive in the first year, about half will do so in the second year
(cumulative pregnancy rate over 90%).

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.

• Measure post-void residual volume by bladder scan or catheterisation in women with symptoms suggestive of voiding dysfunction or recurrent UTI.
• Use a bladder scan in preference to catheterisation on the grounds ofacceptability and lower incidence of adverse events.
• Undertake a urine dipstick test in all women presenting with urinary incontinence.
• Undertake routine digital assessment to confirm pelvic floor muscle contraction before the use of supervised pelvic floor muscle training for the treatment of urinary incontinence.

Do not use the Q-tip, Bonney, Marshall and Fluid-Bridge tests in the assessment of women with urinary incontinence.

• Offer bladder training lasting for a minimum of 6 weeks as first-line treatment to women with urgency or mixed urinary incontinence.
• If women do not achieve satisfactory benefit from bladder training programmes, the combination of an overactive bladder medicine with bladder training should be considered if frequency is a troublesome symptom.
• Offer a face-to-face or telephone review 4 weeks after starting a new medicine for overactive bladder

In clinically suspected DVT or PE, treatment with low-molecular-weight heparin (LMWH) should be commenced immediately until the diagnosis is excluded by objective testing, unless treatment is strongly contraindicated.

Compression duplex ultrasound should be undertaken where there is clinical suspicion of DVT.
If ultrasound is negative and there is a low level of clinical suspicion, anticoagulant treatment can be discontinued.

If ultrasound is negative and a high level of clinical suspicion exists, anticoagulant
treatment should be discontinued but the ultrasound should be repeated on days 3 and 7.

Intravenous unfractionated heparin is the preferred, initial treatment in massive PE with cardiovascular compromise.

Do not use pad tests in the routine assessment of women with urinary
incontinence.

• 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.

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