Woman taking drospirenone/ethinyl estradiol oral contraceptive, diagnosed with DVT and PE 18 months prior to pregnancy. Enoxaparin sodium prophylaxis prescribed from start of pregnancy. On-going headache symptoms of CVT from about 16 weeks. CVT finally diagnosed and treatment started at about 22 weeks. (Enoxaparin sodium prophylaxis failure, indicated) Fetal demise resulting from placental clotting at about 26+ weeks. What is the percentage of risk to the fetus that could be determined to have existed at the time the CVT was diagnosed at about 22+ weeks?
It is unlikely that there was any risk to the fetus from the CVT. In all probability this patient has an underlying hypercoagulable disorder that predisposed her to DVT, PE, CVT as well as the fetal demise.