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Pulmonary thromboembolism and its complications in a patient in labour
  1. Neetha Vyas,
  2. Neetha Poonja,
  3. Balika Shetty and
  4. Supriya Rai
  1. OBG, KS Hegde Medical Academy, Mangalore, Karnataka, India
  1. Correspondence to Dr Neetha Vyas; nvyas{at}nitte.edu.in

Abstract

Venous thromboembolic event in pregnancy is a rare but dreaded complication. When it occurs in labour, it presents with sudden severe fetal distress and maternal haemodynamic compromise. We present to you a case where in patient was taken up for emergency caesarean section for severe fetal distress. Intraoperative ECG showed right heart strain. Hence, an immediate bedside echocardiography was done in medical intensive care unit and it picked up a swirling thrombus in right atrium which immediately got dislodged to pulmonary vessels. Postcaesarean, we faced challenge of controlling active bleeding from atonic uterus with non-surgical techniques (Bakri balloon tamponade and uterine artery embolisation) before considering anticoagulation therapy for pulmonary embolism. The patient recovered well after anticoagulation treatment.

  • pulmonary embolism
  • pregnancy

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Footnotes

  • Contributors NV, NP, BS and SR have all contributed in the management of the patient. NP and BS have helped in review of literature. All authors have gone through the manuscript and agreed.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.