Question 18 -
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One spontaneous episode of PE is treated by warfarin for 6 months. Only lifelong if identified cause for the PE e.g. thrombophilia. If asymptomatic not put on anticoagulation for life. If >2 spontaneous episodes plan is more uncertain but may veer towards anticoag for life.
Third trimester and postpartum are the maximum risk periods for thrombosis is pregnancy.
DDAVP can be used for prophylaxis in bleeding disorders e.g. vWD NOT in thrombophilia. Prophylaxis for thromboembolic disease is LMWH, heparin or warfarin.
The response to LMWH is more predictable than heparin and no monitoring is usually required. ? does this make less of a risk of bleeding complications?
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