Pregnancy complication - Venous thromboembolism Flashcards
How many risk factors for VTE would prompt consideration of VTE prophylaxis with LMWH?
3 or more
What are risk factors for VTE in a pregnant woman?
- Age > 35 years
- BMI > 31
- Smoker
- Parity > 3
- Multiple pregnancy
- Assisted reproduction
- Haematological disease - Sickle cell, thrombophilia, past thromboembolism
- Pre-eclampsia
There are many more than this…
If somone was high risk for VTE, what measures would you take in managing them?
Antenatal thromboprophylaxis with LMWH - enoxaparin
If someone was intermediate risk of VTE during pregnancy, how would you manage them?
Consider antenatal prophylaxis with LMWH
What thromboprophylaxis is needed for women following C-section?
LMWH heparin for 7 days postpartum
What LMWH is usually used as thromboprophylaxis in pregnancy?
Enoxaparin
How would you manage a massive PE in a pregnant woman?
- Consider need for thrombolysis vs percutaneous embolectomy
- Consider LMWH - twice daily enoxaparin
Should LMWH be continued through labour?
No - stop it and keep woman well hydrated
How long should you wait until LMWH is started again following an epidural?
>4h