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DEFINITION
THROMBOPHLEBITIS is an inflammation with the formation of blood clots.
When thrombophlebitis occurs in the postpartal
FEMORAL THROMBOPHLEBITIS
It was formerly called milk leg or phlegmasia alba
involved.
Although the site in thrombophlebitis is a vein, an
accompanying arterial spasm often diminishes arterial circulation to the leg as well
femoral thrombophlebitis last only for a few days, but the full course of the disease takes 4 to 6 weeks before it is resolved. The affected leg may never return to its former size and may always cause discomfort after long periods of standing.
PELVIC THROMBOPHLEBITIS
Involves the ovarian, uterine or hypogastric veins Usually occurs after a mild endometritis
puerperium
CAUSES
The fibrinogen level is still elevated from pregnancy,
leading to increased blood clotting Dilatation of lower extremity veins is still present as a result of pressure of the fetal head during pregnancy and birth The relative inactivity of the period or a prolonged time spent in delivery or birthing room stirrups lead to pooling, stasis, and clotting of blood in the lower extremities
RISK FACTORS
OBESE WOMEN VARICOSE VEINS 30 YEARS OF AGE AND OLDER WITH INCREASED PARITY
PATHOPHYSIOLOGY
THROMBOSIS
VIRCHOWS TRIAD
Redness
Increased local temperature Dull, aching tightness in the calf, especially when
Femoral Thrombophlebitis:
Chills and pain in the affected leg Leg has a white or drained appearance
- It is used to determine the presence of a deep vein thrombophlebitis. The patient lies prone on the table with the knee fully extended. The examiner passively dorsiflexes the patients ankle while palpating the calf. Pain in the calf and/or pain with palpation is considered a positive test
Doppler ultrasonography or contrast venography
Pelvic Thrombophlebitis
Fever Chills General malaise If infection is severe, it results to pelvic abscess Could also result to lung, kidney or heart valve abscess
MANAGEMENT
may be used to keep pressure of the bedclothes off the affected leg, both to decrease the sensitivity of the leg and to improve the circulation.
Ambulate as soon after birth as you are able. When resting in bed, wiggle your toes or do leg lifts
inflammation. Be certain that the weight of the hot pack or pad does not rest on the leg, causing an obstruction to flow of blood
the other parts of her body to lower risk of blood clotting such as reading material about newborns.
Measure blood coagulation levels daily before
administration of anticoagulant. Depending on the drug prescribed, a baseline activated partial thromboplastin time (APTT) or prothrombin time (PT) is obtained
Pharmacologic mangement:
Administration of anticoagulants to prevent blood
clotting
Analgesics to relieve pain
Classification : Anticoagulant Action: Heparin blocks the conversion of prothrombin to thrombin and of fibrinogen to fibrin, decreasing clotting ability and resulting in the inhibition of thrombus and clot formation. It is used to prevent thrombosis and pulmonary embolism Pregnancy Risk Category: C
may be used to keep pressure of the bedclothes off the affected leg, both to decrease the sensitivity of the leg and to improve the circulation.
Caution mother to tell her physician before her next
Surgical management:
If abscess forms, it can be located and incised by
laparatomy if necessary.