HAEMATOLOGY

Question 1

List 6 haematological changes in pregnancy

Answer 1

Expanded plasma volume
Mild neutrophilia
Mild thrombocytopenia
Increased procoagulant factors
Decreased natural anticoagulants
Diminished fibrinolysis

Question 2

List the changes in procoagulants that occurs in pregnancy

Answer 2

Increase in the following:
- Factor II (prothrombin)
- Factor VII (start of extrinsic pathway)
- Factor VIII (

Question 3

List risk factors that may contribute to a patient requiring postnatal VTE thromboprophylaxis

Answer 3

Previous VTE
age
obesity (BMI >30)
PPH >1L
Emergency vs elective CS
long labour
extensive perineal repair required
surgical procedure in puerperium (as well as CS)
systemic infection
medical comorbidity

Question 4

List risk factors antenatally that contribute to need for VTE

Answer 4

previous VTE
Age
Obesity BMI >30
smoking
immobility
varicose veins
multiple pregnancy
multiparity
ART
Hyperemesis

Question 5

What is the advantage of LMWH over UFH

Answer 5

• longer half life meaning less frequent dosing
• do not have to monitor the dosing with APTT measurement
• less risk of haemorrhage
• less risk of osteoporosis, skin changes and HIT

Question 6

what are the advantages of UFH over LMWH?

Answer 6

• can stop easily
• fully reversible with protamine sulfate
• in patients with renal impairment can be used as not renally cleared