Pulmonary embolism during and after pregnancy

Stone, Sarah E.; Morris, Timothy A.

doi:10.1097/01.ccm.0000183157.15533.4c

Cited by 57 publications

(51 citation statements)

References 57 publications

(81 reference statements)

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“…4) Some mechanisms are also explained with Virchow's classic triad of factors underlying venous thrombosis; hypercoagulability, venous stasis, and vascular damage. 9) We therefore considered that resolving the pregnancy as soon as possible would be very important for improving the hypercoagulability stage and for recovery of her general condition.…”

Section: Discussionmentioning

confidence: 99%

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Massive Pulmonary Thromboembolism in Pregnancy Rescued Using Transcatheter Thrombectomy

et al. 2007

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SUMMARYWe report a rescued 37-year-old woman in her 30 th week of gestation with massive pulmonary thromboembolism who was admitted to our cardiac care unit with progressive dyspnea and 2 episodes of syncope. Helical chest CT showed massive pulmonary thromboembolism of both pulmonary arteries. Although 26,000 U/day of heparin was administered following insertion of a temporary filter, hemodynamic evaluation documented no improvement. Since pulmonary artery (PA) pressure increased from 62/22 mmHg to 80/ 24 mmHg just after an emergency cesarean section on day 2, an emergency transcatheter thrombectomy was performed and it showed decreased PA pressure following extensive thrombus aspiration. Mother and baby were discharged with no complications.(Int Heart J 2007; 48: [269][270][271][272][273][274][275][276]

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Section: Discussionmentioning

confidence: 99%

“…Heparin, a large molecule, is the mainstay of therapy for PTE during pregnancy 4) because it does not cross the placenta, 5) and does not carry risks of fetal hemorrhage or teratogenesis. Although its use during pregnancy seems to be safe, the dosing remains controversial.…”

Section: Discussionmentioning

confidence: 99%

Massive Pulmonary Thromboembolism in Pregnancy Rescued Using Transcatheter Thrombectomy

et al. 2007

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“…Pulmonary embolism (PE) is the third cause of maternal death in France [35], and its incidence culminates in postpartum period [36][37]. Last ESC recommendations updated severity stratification and goal directed treatment for acute PE [38].…”

Section: Pulmonary Embolismmentioning

confidence: 99%

Cardiovascular emergencies and cardiac arrest in a pregnant woman

Ducloy-Bouthors

Gonzalez-Estevez

Constans

et al. 2016

Anaesthesia Critical Care & Pain Medicine

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“…The enlarging uterus may also induce a selective compressive effect on the common iliac vein. Pregnancy causes hematologic changes including increased circulating levels of clotting factors, decreased protein S levels and resistance to activated protein C [10]. The generation of fibrin is increased, and fibrinolytic activity is decreased.…”

Section: Pregnancy and Labor Physiologymentioning

confidence: 99%

Pulmonary Hypertension in Pregnancy: Critical Care Management

et al. 2012

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Pulmonary hypertension is common in critical care settings and in presence of right ventricular failure is challenging to manage. Pulmonary hypertension in pregnant patients carries a high mortality rates between 30–56%. In the past decade, new treatments for pulmonary hypertension have emerged. Their application in pregnant women with pulmonary hypertension may hold promise in reducing morbidity and mortality. Signs and symptoms of pulmonary hypertension are nonspecific in pregnant women. Imaging workup may have undesirable radiation exposure. Pulmonary artery catheter remains the gold standard for diagnosing pulmonary hypertension, although its use in the intensive care unit for other conditions has slowly fallen out of favor. Goal-directed bedside echocardiogram and lung ultrasonography provide attractive alternatives. Basic principles of managing pulmonary hypertension with right ventricular failure are maintaining right ventricular function and reducing pulmonary vascular resistance. Fluid resuscitation and various vasopressors are used with caution. Pulmonary-hypertension-targeted therapies have been utilized in pregnant women with understanding of their safety profile. Mainstay therapy for pulmonary embolism is anticoagulation, and the treatment for amniotic fluid embolism remains supportive care. Multidisciplinary team approach is crucial to achieving successful outcomes in these difficult cases.

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Pulmonary embolism during and after pregnancy

Cited by 57 publications

References 57 publications

Massive Pulmonary Thromboembolism in Pregnancy Rescued Using Transcatheter Thrombectomy

Massive Pulmonary Thromboembolism in Pregnancy Rescued Using Transcatheter Thrombectomy

Cardiovascular emergencies and cardiac arrest in a pregnant woman

Pulmonary Hypertension in Pregnancy: Critical Care Management

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