Which labs should be monitored for a postpartum client on heparin prophylaxis?

• A. Complete blood count.
• B. aPTT and platelet count.
• C. Liver function tests.
• D. Serum electrolytes.

Answer: (B)

Monitoring anticoagulation in a postpartum client on heparin prophylaxis centers on how the drug affects clotting and watching for a potential adverse reaction. The aPTT is used because heparin acts by enhancing antithrombin and inhibiting clotting factors in the intrinsic pathway, so this test reflects the level of anticoagulation and helps keep the dose within a safe, effective range. Tracking the platelet count is crucial because heparin can cause heparin-induced thrombocytopenia, a serious immune-mediated drop in platelets that can lead to further clotting problems; checking platelets baseline and periodically allows early detection.

Other labs like a plain complete blood count don’t measure the anticoagulant effect, and liver function tests or serum electrolytes don’t indicate how heparin is working or its safety in this context. If low-molecular-weight heparin is used, routine aPTT monitoring isn’t typically required, though platelet counts may still be monitored due to HIT risk.