RT Book, Section
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
SR Print(0)
ID 1143141224
T1 Emergencies After 20 Weeks of Pregnancy and The Postpartum Period
T2 Tintinalli's Emergency Medicine Manual, 8e
YR 2017
FD 2017
PB McGraw-Hill Education
PP New York, NY
SN 9780071837026
LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1143141224
RD 2022/08/16
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.