DVT in Pregnancy Flashcards Preview

Ob/Gyn > DVT in Pregnancy > Flashcards

Flashcards in DVT in Pregnancy Deck (10)
Loading flashcards...

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)


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


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


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)
2. Thrombocytopenia


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

Avoid estrogen – use progestin-only methods of contraception

Irregular uterine bleeding