VTE Flashcards
Name Virchows triangle
- Hypercoagulability
- Venous stasis
- Ventricular endothelial damage
Pregnancy is a…
Prothrombotic/ hypercoagulable state
What is meant by hypercoagulablity in VT?
Activations of coagulation mechanism
Increased levels of clotting factors as pregnancy progresses
What is meant by venous stasis in VT?
Hormonally induced decrease in venous tone
Obstruction to venous flow as uterus enlarges
What is meant by ventricular endothelial damage in VT?
Damage to pelvic floor as foetus passes pelvis
Other causes: smoking, PET, diabetes
What are the risk factors for VTE during pregnancy?
- Previous VTE
- Thrombophilia
- > 35
- Obesity
- Smoking
What are the obstetrics risk factors for VTE during pregnancy?
- Multiple pregnancy
- ART
- PET
- C- section
- PPH
What are the symptoms of VTE?
- Leg pain and swelling
- Increased temperature
What is the diagnosis of VTE?
- Investigate leg symptoms
- Doppler ultrasound
- MRI
What is the management of VTE?
- Unfractioned heparin Prevents formation of thrombin - Low molecular weight heparin . Fragmin (Deltaparin) . Clexane (Enoxaparin sodium) - Warfarin Oral coagulant that interferes with vit K action Passes placenta so shouldn't be used during pregnancy but can be used postnatally and when BF - Aspirin Prevents platelet aggregation - Streptokinase Dissolves clots - TEDS
What are the side effects of anticoagulant therapy?
- Haemorrhage
- May need antagonist:
. Warfarin - Vit K
. Heparin - Protamine sulphate - Long term heparin may lead to:
. Thrombocytopenia
. Osteoporosis
. Fetal haemorrhage
What are the midwifery responsibilities for VTE?
- Risk assessment at AN booking
- Refer high risk women
- Health promotion
- Care planning
- Look for signs
- Contraception
