VTE Flashcards
Describe the pathophysiology behind VTEs (10)
1) pregnant women in a hyoercoaguble state increases clotting factors fibrinogen thrombin factor IV, I, VII, IX, VIII to help the blood clot to reduce PPH risk but increases DVT risk
2) fibrinolytic inhibited not as good at breaking down clots
3) increased presence of tissue factor released from endothelial cell damage increases rate of clotting
4) reduced venous stasis due to lower limb venous return from effect of progesterone relaxing blood vessel walls and weight of uterus compresses right iliac artery and left iliac vein and chorion vein making it 85% more likely to have DVT on the left
5) blood in contact with cell walls for longer due to reduced stasis and progesterone causes microscopic endothelial cell damage so RBCs catch on damage and form clot
6) all demonstrated in Virchows triad
Risk factors for VTE
Age- 35 or more BMI- over 30 Smoking Parity- 3 or more Family HX of anti thrombin defiency protein C+S deficiency Anti phospholipid syndrome Previous VTE paraplegia Co-morbidities Hypertension Cancer Pre eclampsia Multiple pregnancy Hyperemisis LSCS prolonged labour PPH Immobility Systemic infection Long distance travel
Signs and symptoms for VTE
Unilateral/bilateral swelling Redness/discolouration Weight bearing difficulty on one leg Low grade pyrexia Lower abdo pain/groin pain Pruritis Dyspnoea Chest pain Coughing with blood Tachycardia Calf pain
You’re on the day care unit and Sarah comes in 2 days PN complaining of a swollen calf and calf pain what is your management plan?
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