A pregnant woman develops deep, boring pain of her left thigh muscles associated with swelling and enhanced warmth of the same leg. The pain is worsened by extending the foot. The superficial veins of the leg are engorged. Her condition puts her at risk for which of the following?
The patient has clinical findings strongly suggestive of deep venous thrombosis (DVT). Pain that increases upon extension of the foot is referred to as Homans' sign. Pregnancy, paicularly during the third trimester, induces a hypercoagulable blood state (possibly to limit the chance of fatal hemorrhage during delivery), which can manifest as DVT. The major complication of DVT is pulmonary embolism, which may be massive and can cause sudden death. Renal failure can be a serious problem in pregnancy, but is not related to deep vein thrombosis. Cerebral hemorrhage and hepatic infarction are complications of preeclampsia. Ref: Cunningham F.G., Leveno K.J., Bloom S.L., Hauth J.C., Rouse D.J., Spong C.Y. (2010). Chapter 47. Thromboembolic Disorders. In F.G. Cunningham, K.J. Leveno, S.L. Bloom, J.C. Hauth, D.J. Rouse, C.Y. Spong (Eds), Williams Obstetrics, 23e.
Acute renal failure
Cerebral hemorrhage
Hepatic infarction
Pulmonary embolus