A 35-year-old woman, gravida 2, para 1, who is 30 weeks pregnant, has been admitted to your ICU with pre-eclampsia. Her blood pressure is 160/100 mmHg treated with hydralazine and  metoprolol  prior  to  her  admission.  IV  vasodilators  are  being  considered.  She  has moderate proteinuria,  normal liver function and a platelet count of 120 x 109. There is no evidence of foetal distress. Her significant past history included a Factor V Leiden mutation and a history of proximal vein thrombosis during her first pregnancy.

1.   What pharmacological regime would you recommend for DVT prophylaxis and why? The rest of the viva was a discussion  on thromboprophylaxis  in pregnancy  including  the
results of the recent PROTECT study.

Disclaimer: the viva stem above is the original CICM stem, acquired from their publicly available past papers. However, because the college do not make the rest of the viva text or marking criteria available, the rest has been confabulated. It sounds like a plausible viva and it can be used for the purpose of practice, but all should be aware that it does not represent the "true" canonical CICM viva station.