DVT in Pregnancy/ Pulmonary Embolism

Question 1

is the risk of DVT in pregnancy reduced or increased

Answer 1

increased

Question 2

what are the risk factors

Answer 2

parity - 3
smoker
history of DVT
age >35
BMI>30
multiple pregnancy
family history 
pre-eclampsia
prolonged labour 
CS
stillbirth 
post-partum haemorrhage > 1000ml

Question 3

how many risk factors are needed to commence prophylactic treatment

Answer 3

4 or more

Question 4

what prophylactic drug is used to manage DVT

Answer 4

low molecular weight heparin

Question 5

when do you start the drugs

Answer 5

high risk:
beginning of pregnancy till post-natal for 6 weeks

moderate risk:
start at 28 weeks till post-natal for 6 weeks

Question 6

pulmonary embolism prophylaxis management

Answer 6

low molecular weight heparin

Question 7

investigations for DVT and PE

Answer 7

DVT:
duplex USS

PE:
ECG and bloods
V/Q
CXR

Question 8

what investigation has little use in pregnancy and why

Answer 8

d-dimer, it will be naturally raised in pregnancy

Question 9

what should be monitored when patients are on LMWH

Answer 9

anti-Xa

Question 10

what risk factor automatically qualifies patient’s for prophylaxis

Answer 10

history of DVT