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.

Active management of Third stage of Labor includes -

1. Administer 10 IU of oxytocin by intramuscular injection with the birth of the anterior shoulder or immediately after the birth of the baby and before the cord is clamped and cut.

2. After administering oxytocin, clamp and cut the cord- Do not clamp the cord earlier than 1 minute from the birth of the baby unless there is concern about integrity of the cord, or well being of the baby ( e.g heart rate below 60 bpm AND not getting faster) .
Clamp the cord before 5 minutes.

3. After cutting the cord, use controlled cord traction- only after administration of oxytocin and signs of separation of the placenta.

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%.

Methotrexate adjuvant therapy should not be used for expectant management as it is of unproven benefit and has significant adverse effects.