Flashcards in DVT in Pregnancy Deck (10)
Risk of DVT pregnancy versus non-pregnancy? Mechanism for DVT in pregnancy?
Increased levels of clotting factors (fibrinogen) and venous stasis (Uterus presses on vena cava)
Holmans sign? Use in practice?
Test for DVT in calves – Dorsiflexion of the foot to elicit tenderness
May itself cause embolization of clots. Do not use
Duplex ultrasound flow study?
Real-time sonography and Doppler flow to assess for DVT
Management of DVTs in pregnancy?
Anticoagulation, bed rest, extremity elevation
Type of anticoagulation to use in pregnancy?
Heparin (Does not cross placenta well) preferable over Coumadin (Coumadin linked to congenital abnormalities and more difficult to reverse)
Mechanism of action of heparin?
Thrombin inhibitor blocks conversion if fibrinogen to fibrin – stabilizes clock and inhibits propagation
1. 5-7 days for IV therapy
2. Then Subcutaneous heparin to maintain PTT between 1.5-2.5 for three months
3. Then Prophylactic heparinization for remainder of pregnancy and six weeks postpartum
Normal lower limit of platelet count? In pregnancy?
150,000 versus 120,000
Consequences of long-term heparin use?
1. Osteoporosis (the inhibition of vitamin K)