A 39-Year-Old Pregnant Woman with Pulmonary Emboli on Long Term Anticoagulation

Mehta,; Bhatia, Karishma; Am, Dave; Zs, Depew

doi:10.7759/cureus.1356

Cited by 3 publications

(1 citation statement)

References 9 publications

(10 reference statements)

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“… 11 While intrinsic lung compliance is unaltered, chest wall and total compliance decrease by approximately 30% in pregnancy. 11 – 13 The risk of respiratory failure is further increased by the decrease in functional residual capacity (FRC). Mechanical ventilation in pregnant women poses many challenges, including the increased risk of intubation failure due to increased airway edema, decreased FRC, and higher risk of aspiration.…”

Section: Discussionmentioning

confidence: 99%

Severe and critical COVID-19 in pregnancy: A case series from Montreal

et al. 2021

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Background Optimal obstetric management for women with coronavirus disease (COVID-19) is not known. We describe the management of six pregnant women requiring in-hospital care for severe COVID-19. Methods A retrospective chart review was conducted to identify pregnant women who tested positive for Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) between 15 March and 30 June 2020. A subset of women meeting criteria for severe COVID-19 was included. Results Four women required non-invasive supplemental oxygen therapy and two required mechanical ventilation. Four women were discharged from hospital undelivered and two required preterm delivery. One woman had a pulmonary embolism, and two required re-admission for worsening symptoms. Conclusion Management of pregnant women with severe COVID-19 is complex and should involve multidisciplinary expertise. Avoiding early delivery may be a safe option. We recommend an individualized approach to care, including careful consideration of the expected risks and benefits of expectant obstetric management versus delivery.

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Section: Discussionmentioning

confidence: 99%

Severe and critical COVID-19 in pregnancy: A case series from Montreal

et al. 2021

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Successful management of Klippel–Trenaunay syndrome in a pregnant Asian woman

Xiao

Peng

et al. 2020

Medicine

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Rationale: Klippel–Trenaunay Syndrome (KTS) is a congenital vascular disease characterized by cutaneous hemangiomas, venous varicosities, and limb hypertrophy. Although extremely rare in pregnant women, the present vascular alterations may be aggravated, consequent to postural and hormonal changes inherent to the pregnancy. Pregnancy is not advised in KTS women due to increased obstetrical risk. Patient concerns: A 31-year-old pregnancy woman presented with prominent vascularity in pelvis, right lower limb, spleen, and liver at 28 weeks of gestation. We started administration of anticoagulant therapy and obstetrics management. Diagnosis: MRI and ultrasound revealed that multiple varicosities in her pelvis, right lower limb, spleen, and liver. She was diagnosed with KTS. Interventions: At her first visit at 28 weeks of gestation, multidisciplinary evaluation had been done. Blood transfusion and iron supplement had been given for anemia correction. Anticoagulant therapy was performed to prevent potential thrombus risk. She had a vaginal delivery with a healthy newborn in her second visit without any complications at the gestation of 36+6 weeks due to rupture of preterm membranes. Outcomes: After successful management, the patient was discharged without any complications 2 days after vaginal delivery. No symptoms of hemorrhage or thrombus were observed. At 6 months follow-up, her right lower toes enlarged obviously, MRI revealed that no obvious changes of hemangiomas was found compared to those during the pregnancy and ultrasound revealed that there was no thrombus in her right lower limb. Lessons: Patients with KTS can be pregnant and have healthy babies safely with regularly monitor and reasonable treatment during pregnancy. A careful follow-up and guidance are necessary.

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A multidisciplinary management approach for patients with Klippel-Trenaunay syndrome and multifetal gestation with successful outcomes

Hogg¹,

Pollack²,

Stephenson³

et al. 2018

Case Reports in Perinatal Medicine

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Background Klippel-Trenaunay syndrome (KTS) is a complex congenital disorder characterized by the classic triad of capillary malformation, venous and lymphatic malformations and limb overgrowth. The incidence of pregnancies affected by KTS is unknown. There is a paucity of literature regarding management and outcomes of affected pregnancies, particularly in multifetal gestations. Case We present two cases of pregnancies affected by KTS and multiple gestations. A multidisciplinary approach with hematology, radiology and anesthesia resulted in two successful pregnancies with no adverse neonatal outcomes. Conclusion Management of pregnancies affected by KTS and multiple gestations should be personalized with a multi-disciplinary approach to avoid morbidity and improve maternal and neonatal outcomes.

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A 39-Year-Old Pregnant Woman with Pulmonary Emboli on Long Term Anticoagulation

Cited by 3 publications

References 9 publications

Severe and critical COVID-19 in pregnancy: A case series from Montreal

Severe and critical COVID-19 in pregnancy: A case series from Montreal

Successful management of Klippel–Trenaunay syndrome in a pregnant Asian woman

A multidisciplinary management approach for patients with Klippel-Trenaunay syndrome and multifetal gestation with successful outcomes

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