DEEP VENOUS THROMBOSIS (DVT)
DVT does predispose to thromboembolic disease. The site of thrombosis is
typically in the lower half of the body. Half of cases occur in the pelvic veins and
half occur in the lower extremities.
Clinical Findings: Symptoms may include pain and increased skin
sensitivity, but there may be no complaints. Signs may include calf pain on
foot dorsiflexion (Homan sign), although these findings are not highly
sensitive or specific. Diagnosis is by duplex Doppler.
Management: Full anticoagulation with IV heparin to increase PTT by 1.5–
2.5 times the control value. Once therapeutic levels are achieved,
subcutaneous heparin is used once. No warfarin is used antepartum because of
teratogenicity concerns with the fetus. Perform thrombophilia workup.