Swollen

A 32 year old lady in her first pregnancy presents at 31 weeks of gestation with pain and swelling of her left leg for one day. She also complains of feeling feverish. There is no history of trauma.

She was diagnosed with gestational diabetes mellitus at 27 weeks, which is well controlled via dietary measures.

Her medical and surgical histories are unremarkable.

Select Relevant Investigations
Full blood count

Performed

WBC/DC: 10,000/mm3
N: 70%
L: 25%
Hb: 12.1 g/dl
Plt: 350,000/mm3
D-Dimer assay

Performed

The D-Dimer assay is positive
Doppler scan Left/LL

Performed

The popliteal and femoral veins show filling defects and are non compressible. Flow augmentation to respiration is absent.
X-Ray Knee Joint

Performed

The x-ray appears normal

Select Relevant Management
Enoxaparin stat
IV Thrombolytics stat
Warfarin stat
Urgent cesarean section