Continuing our discussion here.
All hospitalized patients should be assessed for DVT and PE risk
and, when appropriate, DVT prophylaxis is absolutely recommended.
Subcutaneous heparin. What does that do?
It works on anti-thrombin III quickly.
And it's subcutaneous, it has to be parental, always in a hospital setting. Is that clear?
Now, you might have friends and family, whatever that might be taking -
there are experimental heparin drugs and they're assumed to be FDA approved,
but don't worry about that right now. This is your point; hospital setting, subcu
and it breaks down your clot in thrombin very very quickly. You're gonna be using your PTT.
We also have something called enoxaparin, this is a low molecular weight type of heparin
and these are drugs that are relatively safe to use in pregnancy as well cuz you wanna -
you want to avoid which drug during pregnancy, warfarin at all cost.
Now, with that said, pregnancy - a patient is pregnant. Is she at risk for a DVT? Yes.
We just said anyone who has excess estrogen is pro-thrombotic, right?
And so therefore, are you thinking about giving a blood thinner in a pregnant lady?
It is a possibility.
Do not give warfarin, you're going to wage war upon the fetus and kill your fetus, you don't want that.
So heparin is gonna cross the blood placenta barrier and the fetus is in fact going to be saved, maintained.
Now, in terms of prophylaxis, it's continuous.
So what you would do in here, you're going to then apply compression socks,
TEDS/SCDs, compression stockings, okay.
And this - therefore, you would not be developing your DVT prophylaxis, prophylaxis, prophylaxis for PE.