No varicose veins prior to pregnancy

Hoping for NVD.

Family Hx:

Mother and cousin both have varicose veins

Planning to deliver at Campbelltown Hospital.

Not planning an epidural at this point in time. (did not have with first baby)

Midwife

Jo – Camden Hospital (midwife)

GP: Picton Medical Centre

Obstetricians at Camden Hospital

cc letter to patient

Plan:

Compression maternity stockings

Reduce dose to 40mg daily

Continue for rest of pregnancy and six weeks postpartum (in view of extent of SVT)

Withhold at any sign of labour

No need to see again in clinic unless new concerns arise

Needs to see OB at Camden prior to delivery

meredith.todd@me.com

—–6/04/2018 11:02:07 AM—–

Nelson Haem Reg, Anna

Delightful pregnant lady seen in AHU for above knee SVT

G2P1, uncomplicated pregnancy to date

PMHx: Mild varicose veins,

No previous clots

FHx:

Nil maternal history of clots

She is an IVF baby with a unknown father – ?paternal history

Social

Teacher – 2 days a week

Non-smoker

Non-drinker

Lives at home with partner and 3yo child

History

Last 3 weeks has developed pain over the anterior aspect of the thigh just above the knee, associated tenderness

Ambulatory but sometimes pain on mobilisation (improved following clexane administration)

No shortness of breath or chest pain

No recent illnesses, no cancer red flag symptoms

Does get migraines (normal for her)

Examination

Some bruising and palpable clot above knee, lower thigh on the left

No oedema in the leg

No calf tenderness

US report: occlusive superficial venous thrombosis involving an anterior lower thigh varix (anterior saphenous vein tributory), extending from the patella to an upper limit of 13cm above the knee crease

Bloods – unremarkable aside from mildly elevated DDimer

PLAN

As discussed with Dr Hsu

Clexane 80mg daily

Review in clinic in 6 weeks with repeat scan

Danny is not here – Dr Eslick will review

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