hem5 - pacemaker

[ArchivalUser]

A 26-year-old woman in the 8th week of her first pregnancy is evaluated during a routine examination. Her medical history is significant for a grandmother who developed pulmonary emboli 5 years ago. The remainder of the history is noncontributory, and the physical examination is normal.

Results of genetic analysis indicate that she is heterozygous for the factor V Leiden mutation.

Which of the following is the most appropriate next step in the treatment of this patient?

A Antepartum and postpartum low-molecular-weight heparin
B Postpartum low-molecular-weight heparin
C Antepartum low-molecular-weight heparin and postpartum warfarin
D No treatment required

[ArchivalUser]

i think c is correct.

[ArchivalUser]

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[ArchivalUser]

D)
Key Point
The risk for thrombosis in asymptomatic pregnant women who are heterozygous for the factor V Leiden mutation is low.

Although women with prothrombotic mutations are at increased risk for thrombosis during pregnancy and postpartum, the risk in asymptomatic women who are heterozygous for the factor V Leiden mutation is quite low. Unless there are other risk factors for thrombosis, anticoagulant prophylaxis is generally not required in such patients during pregnancy.

It is suggested that women with one or more unexplained fetal losses in the second or third trimester, particularly when associated with histologic evidence of placental infarction, be evaluated for a thrombophilic defect. There is no consensus as to whether women with other obstetrical complications should undergo evaluation.