Massive pulmonary embolism in pregnancy

Mahfooz Alam Farooqui, Mehar Ali Ayyaril

Research output: Contribution to journalArticle

Abstract

Venous thromboembolic disease (VTE), including deep venous thrombosis (DVT) and pulmonary embolism (PE) is not uncommon during pregnancy. High degree of suspicion should be maintained, as many clinical features of VTE are common during pregnancy such as lower extremity swelling and increased respiratory rate. Threshold to investigate VTE should be low as it is associated with significant morbidity and mortality. Diagnostic tests (venous Doppler, echocardiography, spiral CT, V/Q scan, pulmonary arteriography) should be carefully chosen as dictated by the clinical situation and availability of tests and expertise. DVT or hemodynamically insignificant pulmonary embolism may be managed with systemic anticoagulation. Unfractionated heparin requires continuous intravenous infusion and activated partial thromboplastin time should be monitored. Low molecular weight heparin is safe, can be administered subcutaneously and does not require monitoring unless bleeding is noticed. In the absence of contraindications systemic or local catheter-directed thrombolysis should be attempted for hemodynamically significant pulmonary embolism. Surgical thrombectomy should be considered if thrombolytic therapy is contraindicated. After thrombolysis or thrombectomy, long-term anticoagulation is warranted to prevent recurrence. Warfarin is contraindicated in early pregnancy and risk of bleeding is potentially higher late in pregnancy. We describe a case of massive pulmonary embolism during 8th week of pregnancy successfully treated with systemic thrombolysis.

Original languageEnglish
Pages (from-to)241-244
Number of pages4
JournalPakistan Journal of Medical Sciences
Volume17
Issue number4
Publication statusPublished - 2001

Fingerprint

Pulmonary Embolism
Pregnancy
Thrombectomy
Venous Thrombosis
Hemorrhage
Partial Thromboplastin Time
Doppler Echocardiography
Spiral Computed Tomography
Low Molecular Weight Heparin
Thrombolytic Therapy
Warfarin
Respiratory Rate
Routine Diagnostic Tests
Intravenous Infusions
Heparin
Lower Extremity
Angiography
Catheters
Morbidity
Recurrence

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Massive pulmonary embolism in pregnancy. / Farooqui, Mahfooz Alam; Ayyaril, Mehar Ali.

In: Pakistan Journal of Medical Sciences, Vol. 17, No. 4, 2001, p. 241-244.

Research output: Contribution to journalArticle

Farooqui, Mahfooz Alam ; Ayyaril, Mehar Ali. / Massive pulmonary embolism in pregnancy. In: Pakistan Journal of Medical Sciences. 2001 ; Vol. 17, No. 4. pp. 241-244.
@article{8949ffaedd4444d3b06acd81884ea9fb,
title = "Massive pulmonary embolism in pregnancy",
abstract = "Venous thromboembolic disease (VTE), including deep venous thrombosis (DVT) and pulmonary embolism (PE) is not uncommon during pregnancy. High degree of suspicion should be maintained, as many clinical features of VTE are common during pregnancy such as lower extremity swelling and increased respiratory rate. Threshold to investigate VTE should be low as it is associated with significant morbidity and mortality. Diagnostic tests (venous Doppler, echocardiography, spiral CT, V/Q scan, pulmonary arteriography) should be carefully chosen as dictated by the clinical situation and availability of tests and expertise. DVT or hemodynamically insignificant pulmonary embolism may be managed with systemic anticoagulation. Unfractionated heparin requires continuous intravenous infusion and activated partial thromboplastin time should be monitored. Low molecular weight heparin is safe, can be administered subcutaneously and does not require monitoring unless bleeding is noticed. In the absence of contraindications systemic or local catheter-directed thrombolysis should be attempted for hemodynamically significant pulmonary embolism. Surgical thrombectomy should be considered if thrombolytic therapy is contraindicated. After thrombolysis or thrombectomy, long-term anticoagulation is warranted to prevent recurrence. Warfarin is contraindicated in early pregnancy and risk of bleeding is potentially higher late in pregnancy. We describe a case of massive pulmonary embolism during 8th week of pregnancy successfully treated with systemic thrombolysis.",
author = "Farooqui, {Mahfooz Alam} and Ayyaril, {Mehar Ali}",
year = "2001",
language = "English",
volume = "17",
pages = "241--244",
journal = "Pakistan Journal of Medical Sciences",
issn = "1682-024X",
publisher = "Professional Medical Publications",
number = "4",

}

TY - JOUR

T1 - Massive pulmonary embolism in pregnancy

AU - Farooqui, Mahfooz Alam

AU - Ayyaril, Mehar Ali

PY - 2001

Y1 - 2001

N2 - Venous thromboembolic disease (VTE), including deep venous thrombosis (DVT) and pulmonary embolism (PE) is not uncommon during pregnancy. High degree of suspicion should be maintained, as many clinical features of VTE are common during pregnancy such as lower extremity swelling and increased respiratory rate. Threshold to investigate VTE should be low as it is associated with significant morbidity and mortality. Diagnostic tests (venous Doppler, echocardiography, spiral CT, V/Q scan, pulmonary arteriography) should be carefully chosen as dictated by the clinical situation and availability of tests and expertise. DVT or hemodynamically insignificant pulmonary embolism may be managed with systemic anticoagulation. Unfractionated heparin requires continuous intravenous infusion and activated partial thromboplastin time should be monitored. Low molecular weight heparin is safe, can be administered subcutaneously and does not require monitoring unless bleeding is noticed. In the absence of contraindications systemic or local catheter-directed thrombolysis should be attempted for hemodynamically significant pulmonary embolism. Surgical thrombectomy should be considered if thrombolytic therapy is contraindicated. After thrombolysis or thrombectomy, long-term anticoagulation is warranted to prevent recurrence. Warfarin is contraindicated in early pregnancy and risk of bleeding is potentially higher late in pregnancy. We describe a case of massive pulmonary embolism during 8th week of pregnancy successfully treated with systemic thrombolysis.

AB - Venous thromboembolic disease (VTE), including deep venous thrombosis (DVT) and pulmonary embolism (PE) is not uncommon during pregnancy. High degree of suspicion should be maintained, as many clinical features of VTE are common during pregnancy such as lower extremity swelling and increased respiratory rate. Threshold to investigate VTE should be low as it is associated with significant morbidity and mortality. Diagnostic tests (venous Doppler, echocardiography, spiral CT, V/Q scan, pulmonary arteriography) should be carefully chosen as dictated by the clinical situation and availability of tests and expertise. DVT or hemodynamically insignificant pulmonary embolism may be managed with systemic anticoagulation. Unfractionated heparin requires continuous intravenous infusion and activated partial thromboplastin time should be monitored. Low molecular weight heparin is safe, can be administered subcutaneously and does not require monitoring unless bleeding is noticed. In the absence of contraindications systemic or local catheter-directed thrombolysis should be attempted for hemodynamically significant pulmonary embolism. Surgical thrombectomy should be considered if thrombolytic therapy is contraindicated. After thrombolysis or thrombectomy, long-term anticoagulation is warranted to prevent recurrence. Warfarin is contraindicated in early pregnancy and risk of bleeding is potentially higher late in pregnancy. We describe a case of massive pulmonary embolism during 8th week of pregnancy successfully treated with systemic thrombolysis.

UR - http://www.scopus.com/inward/record.url?scp=52549111133&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=52549111133&partnerID=8YFLogxK

M3 - Article

VL - 17

SP - 241

EP - 244

JO - Pakistan Journal of Medical Sciences

JF - Pakistan Journal of Medical Sciences

SN - 1682-024X

IS - 4

ER -