Acute Peripartum Pulmonary Embolism in Mitral Stenosis Patients Undergoing Vaginal Delivery Procedures

Peripartum pulmonary embolism is a life-threatening event caused by a fatal condition. It causes hemodynamic instability and circulatory failure due to obstruction of blood flow. Peripartum pulmonary embolism is one of the highest causes of maternal mortality and morbidity in developing countries. We recently treated a 36-year-old woman who presented with severe dyspnea and decreased level of consciousness shortly after delivering her fourth child. Our evaluation revealed acute peripartum pulmonary embolism with severe mitral stenosis. Given the patient's condition, we opted for endotracheal intubation and mechanical ventilation. We administered unfractionated heparin, vasopressors, and antibiotics. The patient was not eligible for fibrinolytic therapy, surgical thrombectomy, or percutaneous thrombectomy. The patient was managed in an intensive care unit for three days, and her clinical status improved significantly. In health service centers with limited resources, anticoagulant-only management may still be considered on a case-by-case basis, considering the patient's clinical condition.