Thrombo-embolism in Pregnancy:
Refers to the formation of a thrombus within veins.This can occur anywhere in the venous system but the clinically predominant sites are in the vessels of the legs giving rise to deep venous thrombosis and in the lungs resulting in pulmonary embolism.The pathophysiology of venous thrombosis in pregnancy related to increased venous stasis but other factors such as alterations in the balance of proteins of the coagulation and fibrinolytic systems have been implicated.
Risk factors :
- Increased clotting factors during pregnancy.
- Decreased fibrinolytic activity .
- Age and parity.
- Obesity Operative delivery
- Restricted activities due to complications of pregnancy
- Lupus anticoagulant syndrome
- Antithrombin III deficiency.
- Diagnosis:
- History:
- Clinical presentation .
- Risk factors
- Medical history
- Exam.
- Investigations
- Real time duplex u/s.
- Coagulation profile.
- I.N.R.
- Ventilation –perfusion scan.
- MRI.
- Pulmonary angiography
- Treatment:
- Acute phase treatment
- Low molecular weight heparin
- Unfractioned heparin
- Maintainance therapy:
- Prophylaxis;
- High risk group
- Low risk group.