DVT in Pregnancy Flashcards Preview

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Flashcards in DVT in Pregnancy Deck (10):
0

Risk of DVT pregnancy versus non-pregnancy? Mechanism for DVT in pregnancy?

Five-fold increase.

Increased levels of clotting factors (fibrinogen) and venous stasis (Uterus presses on vena cava)

1

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

2

Duplex ultrasound flow study?

Real-time sonography and Doppler flow to assess for DVT

3

Management of DVTs in pregnancy?

Anticoagulation, bed rest, extremity elevation

4

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)

5

Mechanism of action of heparin?

Thrombin inhibitor blocks conversion if fibrinogen to fibrin – stabilizes clock and inhibits propagation

6

Heparin regimen?

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

7

Normal lower limit of platelet count? In pregnancy?

150,000 versus 120,000

8

Consequences of long-term heparin use?

1. Osteoporosis (the inhibition of vitamin K)
2. Thrombocytopenia

9

Mission with history of DVT – use what types of contraception? Complications?

Avoid estrogen – use progestin-only methods of contraception

Irregular uterine bleeding