• Clinicians should consider the use of intravenous tranexamic acid (0.5–1.0 g), in addition to oxytocin, at caesarean section to reduce blood loss in women at increased risk of PPH.
• Consideration should be given to the use of tranexamic acid in the management of PPH.
• According to a Cochrane review- blood loss greater than 400 or 500 ml was less
  common in women who received tranexamic acid in addition to the usual uterotonic agent after vaginal
  birth or caesarean section in a dosage of 1 or 0.5 g intravenously. Tranexamic acid was effective in
  decreasing the incidence of blood loss greater than 1000 ml in women who had undergone caesarean section but not vaginal birth. Further studies are required to investigate the risk of serious adverse effects, including thromboembolic events.

According to Guidance from the British Committee
for Standards in Haematology, it is greater than 2 gram/dL

Genotyping can be undertaken from 16 weeks of
gestation for all except K which can be undertaken from 20 weeks, due to the risk of a false negative
result if performed earlier in pregnancy.

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.

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

In one study, he most common abnormalities were

• T wave inversion (21%)
• S1Q3T3 pattern (15%) - If you know what S1Q3T3 Pattern is - please let us know HERE
• right bundle branch block (18% during pregnancy and 4.2% in the puerperium.

Codeine is converted to active metabolites, mainly morphine. The ultrarapid metaboliser phenotype is due to duplications of the CYP2D6 gene, and prevalence varies by ethnic origin.

Ultrarapid metabolisers who take codeine can have up to 50% higher plasma concentrations
of its active metabolite morphine than extensive metabolisers, with the consequence that there is a risk of serious toxicity even at therapeutic doses of codeine in such individuals.

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.

For anti-K antibodies, referral should take place once detected, as severe fetal anaemia can occur even with low titres.

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