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Postpartum venous thromboembolism — DRCOG MCQ

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HardPostnatalPostpartum venous thromboembolismDRCOG

Two weeks after emergency caesarean birth, a woman develops sudden pleuritic chest pain, dyspnoea, oxygen saturation 93% and a swollen painful calf. What diagnosis is most likely?

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Correct answer: D — Pulmonary embolism secondary to deep-vein thrombosis

The best answer is “Pulmonary embolism secondary to deep-vein thrombosis”. The postpartum state and caesarean birth increase VTE risk, while sudden pleuritic symptoms, hypoxaemia and unilateral calf findings strongly suggest pulmonary embolism from deep-vein thrombosis. This requires immediate hospital assessment and anticoagulation while objective testing is arranged unless contraindicated.

Reference: RCOG Green-top Guideline No. 37b: Acute thromboembolic disease in pregnancy and the puerperium: https://www.rcog.org.uk/media/wj2lpco5/gtg-37b-1.pdf