Maternal diseases in pregnancy

Question 1

Lungeemboli - hvilkte undersøkelser?

Answer 1

• ultralyd/doppler lower limbs if signs of DVT
• CT scan
• perfusion scan (scintigrpahy)

Question 2

Mest vanlig sted å få DVT i svangerskap?

Answer 2

80-90% leftsided. 75% proximal.

Question 3

Symptomer på DVT?

Answer 3

low abdominal, low back or groin pain

swelling of the thigh

CRP and Lck increased

slight fever

Question 4

Hvordan diagnostisere DVT?

Answer 4

UL med doppler

Question 5

Andre lokalisasjoner for venøstromboembolisme?

Answer 5

• sinus vein thrombosis
• upper limbs
• neck: v. jugularis or v. subclavia (associated with ovarian hyperstimulation syndrom (OHSS) in 1. trimester)

Question 6

Hvordan behandle VT?

Answer 6

• LMVH injeksjoner - full dose whole pregnancy and 6-12 months postpartum
• passerer ikke placenta (morsmelk)
  –> dalteparin, enoxaparin (obs går litt over i
  OBS
• timing of delivery –> incrased bleeding, limited epidural.

Question 7

Risikofaktorer for å få VT?

Answer 7

• Tidligere VT
• family history of VT (first degree)
• thrombophilia (strong and week)
• trauma/surgery
• immobilization
• infection
• haemorrhage/blood transfusions
  +++

Question 8

VT-Profylakse hvor lenge?

Answer 8

Fra og med 1. trimester til 6 uker postpartum

Question 9

Herediatry thrombophilia but no previous venous thrombosis - who need prophylactic treatment?

Answer 9

• heterozygote factor V leiden with family history (6 uker postpartum)
• homozygot factor V Leiden (hele svangerskapet + 6 uker postpartum)