In women with suspected PE who also have symptoms and signs of DVT, compression duplex ultrasound should be performed. If compression ultrasonography confirms the presence of DVT, no further investigation is necessary and treatment for VTE should continue.

Pregnant women with suspected PE who have symptoms and signs of DVT should have bilateral compression duplex ultrasound leg studies performed. A diagnosis of DVT may indirectly confirm a diagnosis of PE and since anticoagulant therapy is the same for both conditions, further investigation may not be necessary.

This would limit the radiation doses given to the mother and her fetus.

The algorithm suggested by the RCOG can be viewed HERE

;WD,W

This is a question indeed-

• Before anticoagulant therapy is commenced, blood should be taken for a full blood count, coagulation screen, urea and electrolytes, and liver function tests.
• Performing a thrombophilia screen prior to therapy is not recommended.
• D-dimer testing should not be performed in the investigation of acute VTE in pregnancy. ( D Dimer levels are usually high in pregnancy).
• Compression duplex ultrasound should be undertaken where there is clinical suspicion of DVT.If ultrasound is negative and a high level of clinical suspicion exists, anticoagulant treatment should be discontinued but the ultrasound should be repeated on days 3 and 7.If ultrasound is negative and there is a low level of clinical suspicion, anticoagulant treatment can be discontinued.
• Women presenting with symptoms and signs of an acute PE should have an electrocardiogram (ECG) and a chest X-ray (CXR) performed

The correct answer is- 11 g/ 100 ml at first contact and 10.5 g/100 ml at 28 weeks.

Haemoglobin outside this range should be investigated and iron supplementation considered if indicated.

Pregnant women should be offered screening for anaemia. Screening should
take place early in pregnancy (at the booking appointment) and at 28 weeks
when other blood screening tests are being performed. This allows enough time
for treatment if anaemia is detected.

Source- 1. NICE  Antenatal care for uncomplicated
pregnancies
Clinical guideline
Published: 26 March 2008

2. RCOG Green-top Guideline No. 52

People who are concerned about their fertility should be informed that over
80% of couples in the general population will conceive within 1 year if:
- the woman is aged under 40 years and
- they do not use contraception and have regular sexual intercourse.
Of those who do not conceive in the first year, about half will do so in the second year
(cumulative pregnancy rate over 90%).

In clinically suspected DVT or PE, treatment with low-molecular-weight heparin (LMWH) should be commenced immediately until the diagnosis is excluded by objective testing, unless treatment is strongly contraindicated.

Compression duplex ultrasound should be undertaken where there is clinical suspicion of DVT.
If ultrasound is negative and there is a low level of clinical suspicion, anticoagulant treatment can be discontinued.

If ultrasound is negative and a high level of clinical suspicion exists, anticoagulant
treatment should be discontinued but the ultrasound should be repeated on days 3 and 7.

Intravenous unfractionated heparin is the preferred, initial treatment in massive PE with cardiovascular compromise.

• People who experience fertility problems should be offered counselling because
  fertility problems themselves, and the investigation and treatment of fertility
  problems, can cause psychological stress.
• Counselling should be offered before, during and after investigation and
  treatment, irrespective of the outcome of these procedures.
• Counselling should be provided by someone who is not directly involved in the
  management of the individual's and/or couple's fertility problems.

Read about Intrapartum Care in VBAC-

https://obgresource.com/2021/12/10/intrapartum-care-in-vbac-2/