MASSIVE PULMONARY-EMBOLISM IN LATE PREGNANCY

Citation
Dk. Woodward et al., MASSIVE PULMONARY-EMBOLISM IN LATE PREGNANCY, Canadian journal of anaesthesia, 45(9), 1998, pp. 888-892
Citations number
16
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Anesthesiology
ISSN journal
0832-610X
Volume
45
Issue
9
Year of publication
1998
Pages
888 - 892
Database
ISI
SICI code
0832-610X(1998)45:9<888:MPILP>2.0.ZU;2-P
Abstract
Purpose: To describe the management problems presented by a case of ac ute massive pulmonary embolism in a labouring woman. Clinical Features : A case of massive pulmonary embolism is described in a woman who pre sented in early labour at thirty-eight weeks gestation. Immediate mana gement involved the administration of oxygen and intravenous heparin, and transfer to the regional cardiothoracic centre. Pulmonary angiogra phy confirmed the diagnosis of massive pulmonary embolism, but attempt s at percutaneous catheter disruption of the clot were of only tempora ry benefit. The patient subsequently underwent Caesarean section under general anaesthesia, followed minutes later (because of an abrupt det erioration in her condition) by surgical pulmonary embolectomy. The ou tcome was successful for both mother and child. Conclusion: In cases o f acute massive pulmonary embolism presenting in late pregnancy and in labour, the risks and benefits of surgical embolectomy, pharmacologic al thrombolysis, or attempts at mechanical clot disruption have to be weighed on an individual basis. Management at the referral centre was facilitated by having cardiothoracic and obstetric facilities on the s ame site.