VTE in pregnancy

Question 1

what puts a pregnant woman at greater risk of VTE?

Answer 1

dehydration (i.e. hyperemesis gravidarum)
immobility 
infection 
pre-eclampsia 
obesity 
smoker

Question 2

what is the treatment for DVT / PE in pregnancy?

Answer 2

LMWH i.e. Dalteparin

Question 3

what are the side effects of dalteparin use?

Answer 3

haemorrhage
epidural haematoma
thrombocytopenia
prosthetic cardiac valve thrombosis

Question 4

why are pregnant women at increased risk of VTE?

Answer 4

hypercoaguable state - helps clotting post delivery
progesterone causes vasodilatation so increase in stasis as well as compression from enlarging uterus
vessel wall damage during labour or c-section

Question 5

is dalteparin okay to take when breast feeding?

Answer 5

not contraindicated but advice against

Question 6

when is VTE prophylaxis given in pregnancy ?

Answer 6

if high risk (previous VTE or 4 or more risk factors)
- LMWH immediately until 6 weeks postpartum

if medium risk (3 risk factors)
- LMWH from 12 weeks until 6 weeks post partum