Venous thromboembolism in pregnancy Quiz: Ace Your Exams
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A 28-year-old pregnant woman at 12 weeks of gestation presents to the emergency department with left calf pain that began 2 days ago. The patient reports returning from an 8-hour road trip a day before the onset of symptoms. There is no history of trauma or blood clots. Past medical history is significant for obesity, and the patient is not currently on any medication. There is no significant family history. Temperature is 37°C (98.6°F), heart rate is 80/min, respirations are 18/min, blood pressure is 120/76 mmHg, and oxygen saturation is 99% on room air. On physical examination, the left calf is swollen, erythematous, and tender to palpation, with a 3 cm difference in circumference compared to the right calf. A lower extremity compression ultrasound of the left iliac vein shows poor compressibility. Which of the following is the most appropriate initial management?
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