TY - CHAP M1 - Book, Section TI - Emergencies After 20 Weeks of Pregnancy and The Postpartum Period A1 - Kerrigan, Kathleen A2 - Cydulka, Rita K. A2 - Fitch, Michael T. A2 - Joing, Scott A. A2 - Wang, Vincent J. A2 - Cline, David M. A2 - Ma, O. John Y1 - 2017 N1 - T2 - Tintinalli's Emergency Medicine Manual, 8e AB - Deep vein thrombosis (DVT) and pulmonary embolism (PE) are the leading causes of maternal morbidity and mortality in industrialized nations. Symptoms are similar to those seen in nonpregnant women. Evaluation for DVT should begin with ultrasound of the lower extremities. If there is a concern for PE initiate the evaluation with a chest radiograph. d-dimer may not be helpful to diagnose or exclude thromboembolic disease as levels increase throughout pregnancy. Consensus guidelines recommend obtaining a V/Q scan or CT pulmonary angiography next if the chest radiograph is nondiagnostic. DVT and PE are treated with unfractionated heparin or low-molecular-weight heparin. Do not use warfarin in pregnancy as it crosses the placenta, potentially causing fetal CNS abnormalities and embryopathies such as bone and cartilage abnormalities as well as nasal and limb hypoplasia. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/04/20 UR - accessemergencymedicine.mhmedical.com/content.aspx?aid=1143141224 ER -