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Postpartum venous thromboembolism — DRCOG MCQ

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HardPostnatal CarePostpartum venous thromboembolismDRCOG

A 37-year-old woman is 12 days postpartum after emergency caesarean. She has pleuritic chest pain and shortness of breath. Pulse is 118 bpm, oxygen saturation is 93% and one calf is swollen. What is the most appropriate investigation?

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Correct answer: B — Urgent objective imaging for suspected pulmonary embolism

Postpartum pleuritic chest pain, hypoxia, tachycardia and unilateral calf swelling require urgent objective imaging for VTE, with anticoagulation according to local acute pathways while assessment proceeds. D-dimer cannot safely exclude VTE in this context. A peak flow diary or delayed chest X-ray would miss a potentially fatal diagnosis. The pearl is that postpartum VTE is a medical emergency.

Reference: RCOG Green-top Guideline No. 37b; BNF