• Deep vein thrombosis is the medical term for blood clots in the deep veins of the leg. Deep vein thrombosis, or "DVT" for short, can be dangerous. Veins are the blood vessels that carry blood from the body’s tissues to the heart. Deep veins are located deep in the body, away from the skin’s surface.
  • If a blood clot forms inside a blood vessel, it can clog the vessel and keep blood from getting where it needs to go. When that happens to 1 of the veins deep within the leg, blood can back up and cause swelling and pain.
  • Clotting is a normal process that helps stop bleeding, such as from a cut in the skin. A clot also can form if :-
    • Blood flow is too slow
    • The lining of a vein is damaged
    • A problem in the blood makes it clot more easily
  • When a clot forms in a deep vein, blood flow in the vein slows down and causes the vein to swell. If a piece of a clot breaks free and moves through the blood vessels to the lungs, it is very serious. This condition, called pulmonary embolism (PE), can be fatal. Nearly one third of people who have DVT develop PE. It is important to find and treat DVT early in order to prevent PE.
  • Pregnancy, in itself, is a risk factor for the development of venous thromboembolism (VTE) Increased risk for VTE is highest in the postpartum period.
  • About one half of people who have DVT show any signs or have symptoms. Signs and symptoms of DVT in the ankle, calf, or thigh DVT can cause the following symptoms in the involved leg:
    • Swelling
    • Pain
    • Warmth and redness
    • Constant pain in one leg while standing or walking

    The following tests are used to diagnose DVT:

  • Blood Tests : You may be tested for blood disorders that are known to increase the risk of DVT.
  • Doppler Ultrasound : A handheld device is placed over veins that uses sound waves to check blood flow. Pressure is applied to see if the vein responds normally. This test is most often used to confirm DVT in the legs.
  • Magnetic resonance imaging (MRI) : MRI, a special type of imaging test, can show clots in the legs or pelvis. Its may be limited to situations in which contrast venography cannot be performed, such as in patients with poor kidney function, during pregnancy, or because of allergy to the dye required in contrast venography
  • Venogram : In this test, dye is put into a vein, and an X-ray is taken. The dye can show whether there is a clot in the vein.
  • Spiral computed tomography (CT) : This imaging test is done to see if any clots have moved to the lungs.
  • Ventilation/perfusion (V/Q) scan : This imaging test measures how well air and blood move through the lungs. It is used to diagnose PE.
  • DVT is most often treated with medications. Drugs may include anticoagulants to prevent clots or, less commonly, thrombolytics to dissolve them. Anticoagulants are medications that are commonly called "blood thinners." They do not actually dissolve the clot, but rather help to prevent new blood clots from forming.
  • The treatment of DVT and pulmonary embolism (PE) are similar. In DVT, the main goal of treatment is to prevent a PE. Other goals of treatment include preventing the clot from becoming larger, preventing new blood clots from forming, and preventing long-term complications of PE or DVT.
  • For pregnant women, adjusted dose subcutaneous low molecular weight heparin (LMWH), is recommended rather than adjusted dose intravenous unfractionated heparin (IV UFH) Or vitamin K antagonists. Anticoagulant therapy is continued at least six weeks postpartum.
  • Womenox : Contains Enoxaparin sodium 40 mg/0.4 ml. It is available as prefilled syringe. It allows easy administration in patients, and increases the patient compliance.
  • Evaparin : Each multidose Evaparin cartridge contains : Enoxaparin 300mg/3ml.It is used with Evaparin reusable pen.Evaparin is Safe, convenient and easy to use. The Bidirectional dial allows convenience in dosage correction if required. It allows the dosage titration as require.Allows self administration and better patient compliance.
  • Problem with blood clots in veins is that they can travel to other parts of the body and clog blood vessels there. Pulmonary embolism may develop when a blood clot breaks free from the DVT and travels first to the heart and then onto the lungs. In the lungs, the clot can block the blood supply to part of the lung, causing the lung to collapse leading to heart failure. Pulmonary embolism can be life threatening and requires urgent medical attention.
  • Blood clots that form in the legs, for example, can end up blocking blood vessels in the lungs. This can make it hard to breathe and sometimes, when they are large, can lead to death. When blood clots travel to the lungs doctors call it "pulmonary embolism" or "PE."
  • Enoxaparin must not be administered by intramuscular injection. Enoxaparin is intended for use under the guidance of a physician. For enoxaparin subcutaneous administration, patients may self-inject only if their physicians determine that it is appropriate and with medical follow-up, as necessary. Proper training in subcutaneous injection technique (with or without the assistance of an injection device) should be provided by a healthcare professional. Take enoxaparin sodium injection exactly as prescribed by your doctor. Do not stop taking enoxaparin sodium injection without talking to your doctor. Enoxaparin sodium injection should not be substituted with other heparin or blood thinner medicines.

    The prefilled syringes of enoxaparin are ready-to-use. Enoxaparin should be administered by deep SC injection.

  • Wash and dry your hands thoroughly. Lie in a comfortable position, so that you can see your abdomen. Administration should be alternated between the left and right anterolateral and left and right posterolateral abdominal wall.
  • Clean the injection site with an alcohol swab. Let dry.
  • Remove the needle cap by pulling it straight off the syringe and discard it. Hold the syringe like a pencil in your writing hand.
  • With your other hand, pinch an inch of the cleansed area to make a fold in the skin. Insert the full length of the needle straight down-at a 90° angle-into the fold of skin held between the thumb and forefinger; the skin fold should be held throughout the injection.
  • Press the plunger with your thumb until the syringe is empty. The skin fold should be held throughout the injection. To minimize bruising, do not rub the injection site after completion of the injection
  • If you have any vaginal bleeding or once labour begins you should not inject any further Enoxxaparin. You will be reassessed on admission to hospital by medical staff.
  • Store below 25°C. Do not freeze.

    People sometimes form clots because they have been sitting still for too long. People who travel on long airplane flights, for example, are at increased risk of blood clots. Here are some things you can do to help prevent a clot during a long flight:

  • Stand up and walk around every 1 to 2 hours.
  • Do not smoke just before your trip.
  • Wear loose, comfortable clothes.
  • Shift your position while seated, and move your legs and feet often.
  • Drink plenty of fluids.
  • Wear knee-high compression stockings.
  • Avoid alcohol and medicines that make you sleepy, because they can impair your ability to move around.