Death induced by pulmonary thromboembolism after caesarean section: A case report

Abstract

Deep vein thrombosis and pulmonary embolisms are two of the most common venous thromboembolic events which cause maternal death in Western European countries and the United States. In this case study, a 21-year-old woman delivered a healthy 2,600 g male infant via emergency caesarean section due to an indication of fetal distress following the start of her labor with vertex presentation at the 40th gestational week. After being discharged 10 days after her initial hospitalization, she had to be readmitted seven days later and died suddenly. An autopsy was performed to determine the cause of death in the hospital. The autopsy revealed the lumen of both the femoral and popliteal veins were filled with thrombosis while the lumen of the pulmonary arteries were filled with ante-mortem thrombosis. Additionally, histopathological findings consistent with pulmonary thromboembolism were detected. The aim of this report is to emphasize venous thromboembolic events as they relate to cause of death in the postpartum period following caesarean sections.

Pregnancy-associated Death – Clarifying the Cause of Death and Medico-legal Assessments in Accusations of Malpractice

“…Such deaths from natural causes were the most commonly identified deaths. Information on these causes of death is found in the literature, particularly cases of arterial rupture or dissecting arterial aneurysm with fatal hemorrhage during pregnancy or very shortly after delivery 5 , 35 , 44 , 46 , 50 and cases of fulminant pulmonary embolism 33 . Causes of death reported in the literature include amniotic fluid embolism 7 , 13 , 21 , 25 , 26 , 30 , 31 , 32 and – although this is rare – pregnancy-associated air embolism 4 .…”

“…arteriellen Dissektionen mit letaler Blutung während bzw. zeitnah nach Beendigung der Schwangerschaft 5 , 35 , 44 , 46 , 50 , auch fulminante Lungenthrombembolien 33 . Zusätzlich sind kasuistisch Fruchtwasserembolien 7 , 13 , 21 , 25 , 26 , 30 , 31 , 32 oder – als Rarität – eine schwangerschaftsassoziierte Luftembolie beschrieben 4 .…”