Medicine an Surgery notes

Apr 24th, 2015
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5th February 2009Dr OgindoIntroductionIncidence 0.1% in preg, after C/S is around 12%.10 times more common in pregnant than in nonpregnantOccur at any stage of pregnancy but the puerperium is thetime of highest risk.The subjective, clinical assessment is unreliable inpregnancyP a t h o p h y s i o l o g y 610-fold increase in risk ofVTE. All factors of Virchows triad(venous stasis,hypercoagulability andendothelial injury present) Pregnancy hypercoagulablestate. in severalprocoagulant factors, areduction in endogenousanticoagulant activity and asuppression of fibrinolysis. Venous stasis 20 invenous tone & venousobstruction Vascular injury duringimplantation anddeliveryR I S KF A C T O R SPreexisting risk factors Age >35. Obesity BMI >30 kg/m2. Previousthromboembolism. Thrombophilia Gross varicose veins. Paraplegia. Sickle cell disease. Medical conditions, e.g. IBDor nephrotic syndrome.Transient risk factors.Hyperemesis.Infection, e.g.pyelonephritis.Immobility.Preeclampsia.Prolonged labour.Operative delivery.Excessive blood loss.CLINICALPRESENTATIO NDVT is suspected by: Acute leg pain, Swelling, Redness Tenderness.PTE is suspected by Acute chest pain Shortness of breath. Haemoptysis Hypotension Cyanosis occur in massive PTE.DiagnosisDiagnosis of DVTDiagnosis of PTE1. Chest X-ray2.

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