Massive pulmonary embolism with cardiac arrest in pregnancy: A case report

Publication date: Available online 26 February 2019Source: Journal of Cardiology CasesAuthor(s): Toru Miyoshi, Hideo Kawakami, Reiko Hori, Kazuo Nakanishi, Takehisa Kusumoto, Yusuke Kono, Shinsuke Kido, Akira Oshita, Hiroshi MatsuokaAbstractA 39-year-old woman developed a pulmonary embolism at 28 weeks of gestation, after a 4-week period of bedrest, and required emergencycesarean section due to a decrease in fetal heart rate. Pulseless electrical activity (PEA) developed after intravenous anesthesia. The fetus was delivered 5 min after PEA onset, during cardiopulmonary resuscitation of the mother. Intravenous recombinant tissue-plasminogen activator injection, percutaneous cardiopulmonary support, and 24-h hypothermia therapy were administered to the mother, followed by inferior vena cava filter insertion, combined with catheter thrombus fragmentation and percutaneous thrombectomy. Both the patient and her baby survived.<Learning objective: Massive pulmonary embolism with pregnancy may result in death of both mother and child. In this case, after maternal cardiac arrest due to massive pulmonary embolism, the fetus was delivered by cesarean section, followed by thrombolysis treatment using recombinant tissue-plasminogen activator and percutaneous cardiac pulmonary support, pulmonary thrombectomy which was performed on day 3 was effective. Both the patient and her baby survived.>
Source: Journal of Cardiology Cases - Category: Cardiology Source Type: research