Which is associated with Ted risk of Thromboembolism in a normal pregnancy :
Correct Answer: |ed production of clotting factors by liver
Description: Ans. is b i.e. |ed production of clotting factors by liver Pulmonary thromboembolism is a rare complication of pregnancy but is a significant cause of maternal morbidity and moality. All of us have studied in surgery - Virchow's Traid i.e. factors associated with thromboembolism viz : Endothelial injury Stasis Increased coagulobility. All the elements of Virchow's triad are present during pregnancy viz : i. Endothelial injury ? It may occur during traumatic vaginal delivery or cesarean section. ii. Stasis ? Pregnancy is associated with venous stasis, especially in lower extremities because the enlarging uterus reduces blood return to the inferior vena cava by direct mechanical effect. Hormonal factors also contribute to venodilatation and stasis during pregnancy. Stasis secondary to prolonged bed rest for medical or obstetrical complications also predispose a pregnant woman to increased venous stasis and formation of vascular thrombi. iii. Increased coagulability ? The maternal circulation becomes hypercoagulable as production of clotting factors like fibrinogen and factors VII. VIII, IX and X increase during pregnancy These changes are also associated with decreased fibrinolytic activity. Remember : * Pregnancy is a hypercoagulable state. Levels of fibrinogen are increased in pregnancy. All factors except XI and XIII increase during pregnancy ESR T's during pregnancy. Fibrinolytic activity during pregnancy. Platelet count during pregnancy. Clotting time remains unaffected during pregnancy.
Category:
Gynaecology & Obstetrics
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