What is the initial treatment of suspected acute venous thromboembolism (VTE) in pregnancy?

What is the initial treatment of suspected acute venous thromboembolism (VTE) in pregnancy?

a) LMWH should be commenced immediately until the diagnosis is excluded by objective testing
b) LMWH should not be commenced until the diagnosis is confirmed by objective testing
c) intravenous unfractionated heparin immediately
d) Thrombolytic therapy asap after confirmation with objective testing
e) Surgical embolectomy asap before confirmation

Correct Answer: a) LMWH should be commenced immediately until the diagnosis is excluded by objective testing.
In clinically suspected DVT or PE, treatment with low-molecular-weight heparin (LMWH) should be commenced immediately until the diagnosis is excluded by objective testing, unless treatment is strongly contraindicated.
Collapsed, shocked women who are pregnant or in the puerperium should be assessed by a team of experienced clinicians including the on-call consultant obstetrician.
Intravenous unfractionated heparin is the preferred, initial treatment in massive PE with cardiovascular compromise. An urgent portable echocardiogram or CTPA within 1 hour of presentation should be arranged. If massive PE is confirmed, or in extreme circumstances prior to confirmation, immediate thrombolysis should be considered