Author: Debkumar Chowdhury / Editor: Sarah Edwards / Codes: ObC17, ObP3, SLO3, VC3 / Published: 13/12/2021

A young lady in her mid-30s being 13 weeks pregnant self-presents with a sudden onset left limb pain over the past 24 hours. The symptoms of pain, swelling, and discolouration are noted to be worsening over this period of time. She has undergone immunoglobulin therapy the previous day due to obstetric history of neonatal alloimmune thrombocytopaenia (NAIT).

There is no additional past medical history or family history apart from the complex obstetric history of NAIT leading to an intracranial haemorrhage with termination of pregnancy previously.

Her vital signs are respiratory rate= 18 breaths/min, oxygen saturation= 95% on room air, heart rate= 95 beats/min, blood pressure= 125/65mmHg and temperature= 36 degrees Celsius.

On examination, she is noted to be in discomfort due to the swelling in her left lower limb. She is noted to have normal heart sounds and vesicular breath sounds on auscultation. On examination of her peripheries, there is discoloration of the skin. Pulses were palpable all throughout both lower limbs. She complains of chest discomfort on mobilising with intermittent self-resolving dyspnoea. She undergoes electrocardiogram which indicates incomplete RBBB.