Thromboembolic Disease in Pregnancy

8/11/2019 Thromboembolic Disease in Pregnancy

1/20

Jeannet E.Canda, RN,MAeDCollege of NursingNDDU


2/20

IS THE INFLAMMATION

OF THE LINING OF ABLOOD VESSEL


3/20

- Is the inflammation with the

formation of blood clots.- Usually an extension of an

endometrial infection.


4/20

1. The fibrinogen level is still elevatedfrom pregnancy, leading to

increased blood clotting.2. Dilatation of lower extremity veins

is still present as a result ofpressure of the fetal head duringpregnancy and birth.


5/20

3.The relative inactivity of theperiod or a prolonged time spent

in delivery or birthing room

stirrups leads to pooling, stasis,

and clotting of blood in the lowerextremities.


6/20

Risk Factors:1. Obese

2. Varicose veins3. Previous thrombophlebitis4. Older than 30 years old increased parity


7/20

1. Ambulation and limiting the time a womanremains in obstetric stirrups encourages

:circulation in the lower extremities.::promotes venous return

: decrease the possibility of clot

formation


8/20

2. Varicose veins in pregnancy- wear support stockings for the first 2

weeks after delivery will help increase venouscirculation and prevent stasis.- woman puts them on before she rises in

the morning. Venous congestions hasoccurred if the woman is already walking.

- removed stockings 2x a day


9/20

- involves the femoral, saphenous or poplitealveins.

- Decreased circulation with edema gives a lega white or drained appearance.- Formerly called milk leg or phlegmasia alba

dolens (white inflammation)


10/20

1. Elevated temperature2. Chills

3. Pain4. Redness in the affected leg about 10 days.5. Homans sign( pain in the calf of the leg on

dorsiflexion of the foot) maybe positieve


11/20

1. Bed rest with affected leg elevated.2. Administration of anticoagulants

3. Application of moist heat.4. Provide good back, buttocks and heel care.5. Check for bed wrinkles6. Never massage the skin over the clot.7. Test water temperature (edema decreases

sensation in a womans leg)


12/20

8. Always cover wet, ward dressings with aplastic pad to hold in heat and moisture.

9.Check the womans bed when moist.10. Prescribed Anticoagulant (coumarinderivative or heparin) or thrombolytic agent(Streptokinase or urokinase)


13/20

1 Involves the ovarian, uterine or hypogastricveins.

2. Occurs on the 14thor 15 day of thepuerperium.


14/20

1. Extremely ill with high fever, chills andgeneral malaise.

2. Infection is severe it necroses the vein andresults in a pelvic abscess.3. Systemic (heart, lung, kidney and heart

valve abscess.


15/20

1. Total bed rest2. Administration of antibiotics and

anticoagulant.


16/20

- Is obstruction of the pulmonary artery b ablood clot; it usually occurs as a complication of

thrombophlebitis.


17/20

1. Sharp chest pain2. Tachypnea

3. Tachycardia4. Orthopnea5. Cyanosis6. Pyrexia


18/20

1. Oxygen administration2. ICU


19/20

Cross the placenta and are potentiallyteratogenic at any stage of pregnancy

Complications of warfarin includes, nasalhypoplasia, depressed nasal bridge, irregularbone growth & intracranial fetalhaemorrhage

However , they can be given after deliveryand are safe for lactation


20/20

Thrombo-embolism is amajor cause ofmaternal mortality &morbidity worldwide

Clinical diagnosis is unreliable but oncestrongly suspected, treatment should bestarted until objectively excluded

Dupplex Doppler, x-ray venogram are themain diagnostic tools

Thromboembolic Disease in Pregnancy

Documents

Transcript of Thromboembolic Disease in Pregnancy