Medicine an Surgery notes

Apr 24th, 2015
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Protocol on Prevention and Treatment of Venous Thromboembolism in Pregnancyand the Postpartum PeriodINTRODUCTIONVenous Thromboembolism (VTE) complicates 0.5-3/1000 pregnancies, approximately four times greater than in the non-pregnant population. It occurs with equal frequency in all three trimesters and in the postpartum period and in a woman who has had a previous VTE, the recurrence risk can be as high as 12%. VTE can be a cause of significant morbidity and mortality stemming from extension of a deep vein thrombosis (DVT) or the development of a pulmonary embolus (PE). PE can compromise oxygenation and lead to hypotension and sudden death.RISK FACTORS FOR VTE Kent et al, 2000. Reproduced free of charge with permission from the SOGC.DIAGNOSIS OF DEEP VEIN THROMBOSIS (DVT)Risk factors in addition to clinical signs help make the diagnosis of deep vein thrombosis. The diagnostic test of choice for a DVT is compression doppler ultrasound. If there are 3 or more clinical signs of DVT and the ultrasound diagnosis is delayed it is reasonable to treat based on clinical suspicion.DIAGNOSIS OF PULMONARY EMBOLISM (PE)Risk factors in addition to clinical signs help make the diagnosis of pulmonary embolism. EKG findings and a DVT on Compression Doppler Ultrasound can strengthen your suspicion of PE, but a normal EKG or a normal Compression Doppler Ultrasound does not rule out a PE if you have a strong clinical suspicion. If there

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