anticoagulation-pregnancy

anticoagulation-pregnancy - Anticoagulation in Pregnancy...

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Anticoagulation in Pregnancy and the puerperium Dr. Mohammed Abdalla Egypt, Domiat G. Hospital
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, the optimal use of anticoagulants during pregnancy remains controversial because of a lack of appropriate prospective randomized clinical trials.
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Before Initiating Anticoagulant Therapy full thrombophilia screen (provide information that can influence the duration and intensity of anticoagulation) full blood count and a coagulation screen urea, electrolytes and liver-function tests, to exclude renal or hepatic dysfunction, which are cautions for anticoagulant therapy
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Prophylactic Anticoagulation 1. What are the criteria of risk assessment? 2. Who are the patients candidates for PROPHYLACTIC anticoagulation ? 3. What are the hazards of anticoagulation during pregnancy? 4. Unfractionated or fractionated heparin and in which dose?
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what are the criteria of risk assessment ? 1. increased parity. 2. advanced maternal age. 3. obesity. 4. operative delivery. 5. Any persistent and identifiable hypercoagulable state .either acquired or inherited.( thrombophilia . ).
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RISK CATEGORY HIGH RISK Pr.TED +thrombophilia Pr.TED +family history. Recurrent TEDs. TED in current pregnancy Prosthetic mitral valve LOW RISK ONE previous TED.
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thrombophilia INHERETED ACQURED Protein C deficiency . Protein S deficiency . AT3 deficiency Factor V leiden mutation Homocystinuria APhS . Myeloproliferative disease . Malignancy . Nephrotic syndrome .
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who are the patients candidates for PROPHYLACTIC anticoagulation ? —1-patients judged at low risk : these patients are though to be most vulnerable from the time of delivery throughout the puerperium which is the period of greatest risk. With low dose asprin antenatally.
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2- - patients judged at high risk : these patients receive antenatal ,intranatal ,and postnatal anticoagulation. and throughout the puerperium,. who are the patients candidates for PROPHYLACTIC anticoagulation ?
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What are the Hazards of anticoagulation during pregnancy ? The platelet count should be monitored on a monthly basis to detect heparin- induced thrombocytopenia, which is associated with further thrombotic complications.
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Low molecular weight heparins are a promising alternative because of their long half-lives which give a more predictable dose-effect and reduce the number of daily injections. The risk of heparin-induced thrombocytopaenia is lower. At present, their legal prescription is limited to the 2nd and 3rd terms of pregnancy as prophylactic treatment. What are the Hazards of anticoagulation during pregnancy ?
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Thromboembolic Disease in Pregnancy and the Puerperium Acute Management In women with factors consistent with VTE, anticoagulant treatment should be employed until an objective diagnosis is made RCOG guideline A
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Initial treatment of VTE during pregnancy In clinically suspected DVT or PTE, treatment with unfractionated heparin or
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This note was uploaded on 12/24/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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anticoagulation-pregnancy - Anticoagulation in Pregnancy...

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