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Deep Vein Thrombosis & Pulmonary EmbolismThrombosis is the term used to describe when a blood clot forms in a blood vessel. A deep vein thrombosis (DVT) is a blood clot that forms in a deep vein in the leg, calf or pelvis. A DVT is serious because it can result in the clot breaking off and travelling through the blood stream to the lung, which is called a pulmonary embolism (PE); this can be life threatening although this is extremely rare. Pregnancy carries a higher risk of developing a vein thrombosis due to changes in hormone levels and blood composition, reduced blood flow in the legs, and inactivity. There are also certain conditions or lifestyle choices which add further risk such as being over the age of 35, any family history of the condition, having had more than three babies in the past, severe varicose veins, smoking, your body mass index, certain medical conditions, or having previously had a venous thrombosis. The approximate risk of a venous thrombosis is around 1-2 in 1000 women. At the beginning of your pregnancy, throughout and following the delivery of your baby you will be assessed for any of these risk factors. If it is thought that you are in a high risk category for developing a venous thrombosis your midwife or doctor will recommend and discuss with you the need to commence preventative treatment. Symptoms of a DVT usually present as:a red and hot swollen legswelling of your entire leg or just part of it, or it may just feel heavy.pain and/or tenderness – you may only experience this when standing or walking.Symptoms of a pulmonary embolism may include:sudden difficulty in breathingchest pain or tightnesscoughing up bloodfeeling very unwellcollapsing If you have any of these symptoms you should seek medical advice from your midwife or GP. In the event of chest pain, difficulty in breathing, collapse or any other emergency you should call 999. In order to diagnose or exclude a DVT or PE the hospital may discuss investigation’s to perform usually in the form of a chest X-ray; this can also identify common problems that could be the cause of your symptoms, such as a chest infection, a CT scan (specialised X-ray) of your lungs, or a VQ scan (ventilation/perfusion scan) of your lungs. If you are diagnosed with a DVT or PE your doctor will recommend commencing treatment usually blood thinning injections which work to prevent the clot getting any bigger so your body can gradually dissolve the clot (70), you will be cared for by a consultant obstetrician who will then monitor the pregnancy closely and devise a plan for further care. RCOG Patient Information Leaflet ................
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