Why the study?
Venous thromboembolic events during labour are rare, dreaded complications presenting with sudden severe fetal distress and maternal haemodynamic compromise.
Highlights the successful management of a rare intrapartum pulmonary embolism complicated by postpartum hemorrhage using non-surgical hemostatic techniques before initiating anticoagulation.
Venous thromboembolic event in pregnancy is a rare but dreaded complication. When it occurs in labour, it presents with sudden severe fetal distress and maternal haemodynamic compromise. We present to you a case where in patient was taken up for emergency caesarean section for severe fetal distress. Intraoperative ECG showed right heart strain. Hence, an immediate bedside echocardiography was done in medical intensive care unit and it picked up a swirling thrombus in right atrium which immediately got dislodged to pulmonary vessels. Postcaesarean, we faced challenge of controlling active bleeding from atonic uterus with non-surgical techniques (Bakri balloon tamponade and uterine artery embolisation) before considering anticoagulation therapy for pulmonary embolism. The patient recovered well after anticoagulation treatment.
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Vyas et al. (2022) studied this question.
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