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  • Print publication year: 2005
  • Online publication date: October 2014

7 - Venous thromboembolism in obstetrics and gynaecology

Summary

Venous thromboembolism (VTE) remains the major cause of mortality in association with pregnancy and childbirth and a source of morbidity. Many therapeutic agents may be used in the management of VTE. The choice of the agent and dosage is determined by the setting, balance of risks and benefit, and individual patient factors such as allergy or co-morbidity. Certain therapeutic agents include heparin, warfarin, dextran 70, aspirin and hirudin. The identification of risk factors for VTE provides an opportunity for prevention. The symptoms and signs of deep veins of lower limbs (DVT) include leg pain, swelling, tenderness, oedema, pyrexia, lower abdominal pain and elevated white cell count. Traditionally, unfractionated heparin (UFH) has been used in the initial management of VTE as such treatment reduces the risk of further thromboembolism compared with no treatment. Thromboprophylaxis is effective in reducing the incidence of VTE.

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