Complicated Pregnancy 5 Flashcards Preview

Yr3 Reproductive > Complicated Pregnancy 5 > Flashcards

Flashcards in Complicated Pregnancy 5 Deck (8):
1

Pregnancy is a hyper-coagulable state to protect mother against bleeding post-delivery. What physiological factors contribute to it? [3]
Think of Virchow's triad

- Changes in blood constituents
- Increased stasis due to progesterone and enlarging uterus
- Vascular damage mostly at delivery/c-section

2

What changes in blood constituents occur in pregnancy? Increased [4], decreased [1]

Increased:
- Fibrinogen
- Factor VIII
- VW Factor
- Platelets

Decreased Anti-coagulants like Antithrombin III

3

What women are at particular risk of VTE during pregnancy? [11]

Older women with a high parity
High BMI women, immobility
Smokers, IVDA
Dehydration - hyperemesis

Women with:
- Sickle Cell
- Infections
- Pre-eclampsia
- Thrombophilia
- HTN
- Homocystienuria

H/o VTE or FH

Operative delivery or prolonged labour
Haemorrhage >2L

4

VTE 2 types: DVT [2] and PE [5]
How might a VTE present?

DVT:
- Pain in calf and tender muscle
- Increased girth and redness of calf

PE:
- SOB, pain on breathing (pleuritic chest pain)
- Cough, haemoptysis
- Tachycardia
- Hypoxia
- Pleural rub, RHF

5

How can we prevent VTE in pregnancy?
3 conservative mx techniques
Rx [1]

TED stockings
Hydration
Mobility

If they have 3 or more risk factors we can use prophylactic anti-coagulation up to 6wks post-partum

6

What tests can we do if we suspect a VTE? [4]

ECG, ABG
Doppler US
V/Q scan
CT Pulm. Angiogram (CTPA)

7

How is VTE treated?

ANTI COAGULANTS i.e. LMWH

8

What is homan's sign

on forced dorsiflexion of foot, homan's sign is positive if there is pain - indicative of DVT