medical notes

Apr 16th, 2015
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COAGULATION DISEASES IN PREGNANCYHaemostasisA sequence of interacting events which serve to Protect the integrity of the vascular systemRe-establish patency of small segments which become occluded ComponentsPlatelets- vessel wall interactionClotting factors in plasma/ coagulation systemNatural anti-coagulation system- anti-thrombin, protein C and SFibrinolytic system- plasminCoagulation cascadeIntrinsic pathwayExtrinsic pathwayCommon pathwayCoagulation conditions in pregnancyHaemorrhage- ectopic pregnancy, APH, PPH, Haemophilia, ITPDeep venous thrombosis in pregnancyThrombosis is the process whereby liquid blood flowing through the vessel system turns into a solid mass of platelets and fibrin within the blood vessel.ImportanceDVT is the most serious vascular complication that can occur in pregnancy and puerperium.Thrombosis is disablingPulmonary thrombo-embolism is the worst complication of DVT often with a fatal outcomeIncidence -Infrequent 0.5-0.7%Physiology in pregnancyChanges in blood with coagulation factors and haemoststic mechanisms to protect the pregnant woman from haemorrhage at delivery therefore tendency to clotting. These may have unwanted effects- DVT, PTE are common in pregnancy.Increase in coagulation factors I, VIIINo change in platelet numbersFibrinolytic system is suppressed until after 3rd stagePredispositionPregnancy is a hypercoagulable state- Virchow's triad;Decreased blood flow in leg veinsEndothelial injuries

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