Key result
Therapeutic anticoagulation alone suffices for successful maternal and fetal outcomes in extensive PE without RV strain.
Why the study?
Due to variable presentation and infrequency, little data are available to guide the management of life-threatening pulmonary embolism complicating pregnancy.
Case Report (n=1)
No
In pregnant patients with extensive pulmonary embolism but no right heart strain, therapeutic anticoagulation alone may be a sufficient and safe alternative to thrombectomy.
Prompt interdisciplinary management supports PE care in pregnancy; extends limited evidence but leaves open need for dedicated trials.
Pulmonary embolism remains a well-known and life-threatening complication of pregnancy. Due to the variation in presentation and infrequency of this disease, despite serious potential fetal and maternal complications, there is little data available to guide its management in pregnancy. This case highlights the importance of early detection of the condition and the benefit of an interdisciplinary approach to treatment. This case also demonstrates that in the absence of right heart strain, anticoagulation alone may be sufficient management for large pulmonary emboli.
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Caruso et al. (2026) conducted a case report in Extensive Pulmonary Embolism in Pregnancy (n=1). Therapeutic anticoagulation vs. None (embolectomy considered but deferred) was evaluated on Clinical recovery and successful delivery. In a high-risk pregnant patient with an extensive pulmonary embolism without right heart strain, therapeutic anticoagulation alone was sufficient for successful maternal and fetal outcomes.
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