VTE risk assessment

Question 1

focussed hx

Answer 1

LMP // EDD // how & when confirmed

symptoms

obs hx

gynae hx

PMH // DH // FH // SH

Question 2

explain why we do VTE risk assessment

Answer 2

pregnancy makes blood thicker –> clots

clots settle in leg –> pain // they move –> in lungs, breathing problems & pain

effect on baby

Question 3

ask about RFs (guidelines hopefully given)

Answer 3

age>35 // BMI>30 // smoking

parity>=3 // multiple pregnancies // IVF

pre-eclampsia // varicose veins // previous VTE // thrombophilia

Question 4

summary VTE mx (guidelines hopefully given

Answer 4

lifestyle - mobilise, hydrate, stop smoking

<3RFs - low risk = lifestyle

3RFs - LMWH (subcut) from 28 weeks to 6 weeks postpartum

> 3RFs - LMWH from 1st trimester to 6 weeks postpartum

previous // recurrent // FH VTE - high dose LMWH antenatally & 6 weeks postpartum & pre-pregnancy counselling

Question 5

Tx cessation

Answer 5

stop injection at labour