Why the study?
Does emergency pulmonary embolectomy improve maternal and fetal survival in pregnant patients with massive pulmonary embolism?
Does emergency pulmonary embolectomy improve maternal and fetal survival in pregnant patients with massive pulmonary embolism?
Emergency pulmonary embolectomy during extracorporeal circulation can be a successful and safe treatment for massive pulmonary embolism during pregnancy, avoiding the bleeding risks of thrombolytic therapy.
Successful embolectomy in one pregnant massive-PE case supports feasibility; leaves open maternal-fetal survival benefit versus thrombolysis.
Emergency pulmonary embolectomy was performed successfully on a patient in her second trimester of pregnancy. The patient had severe right ventricular failure due to obstruction of 85% of the pulmonary arterial circulation. Three months after embolectomy she was delivered of a normal infant. The problem of significant but misinterpreted or overlooked clinical and electrocardiographic signs of pulmonary embolism is discussed. Thrombolytic therapy during pregnancy imposes considerable risk of bleeding with deleterious effects on both mother and fetus. In our opinion, emergency embolectomy during extracorporeal circulation is the best treatment in case of massive emboli during pregnancy.
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Blegvad et al. (1989) studied this question.
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