Journal of South Asian Federation of Obstetrics and Gynaecology

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VOLUME 15 , ISSUE 3 ( May-June, 2023 ) > List of Articles

CASE REPORT

Catheter-directed Pulmonary Artery Embolism Thrombolysis: A Life-saving Procedure for Postpartum Pulmonary Embolism: A Near-miss Case

Sheeral Sajjad, Pankaj Banode, Samriddhi Sharma, Shatakshi Sharma

Keywords : Hypercoagulability, Puerperium, Pulmonary embolism, Thrombolysis, Venous thromboembolic events

Citation Information : Sajjad S, Banode P, Sharma S, Sharma S. Catheter-directed Pulmonary Artery Embolism Thrombolysis: A Life-saving Procedure for Postpartum Pulmonary Embolism: A Near-miss Case. J South Asian Feder Obs Gynae 2023; 15 (3):335-337.

DOI: 10.5005/jp-journals-10006-2231

License: CC BY-NC 4.0

Published Online: 31-07-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Abstract

Aim: This case aims to report how timely management with catheter-based thrombolysis was life-saving for a near-miss case of postpartum pulmonary embolism (PE). Background: Near-miss cases describe women who underwent and overcame a serious medical condition while pregnant, giving birth, or after giving birth. During pregnancy and puerperium, there is an increase in the risk of deep venous thrombosis (DVT), PE, stroke, cerebral venous sinus thrombosis (CVST), etc., due to physiological changes that occur, resulting in a state of hypercoagulability. Case description: A 35-year-old female presented in puerperium with dyspnea and chest discomfort of 12-hour duration. She had a full-term normal vaginal delivery 13 days ago. She was later diagnosed with PE and was treated successfully with catheter-directed thrombolysis. Conclusion: Near-miss cases of PE require proficient assessment of the presentation, risk factors, and treatment options. As such, cases are associated with increased mortality when treatment is delayed. Due to the acute presentation of the patient, the decision for catheter-directed thrombolysis was made for immediate resolution of the thrombus. We believe this procedure was lifesaving in this situation and is an effective therapeutic choice in such scenarios. Clinical significance: Acute PE is a catastrophic situation that is mostly seen in the postpartum period. The clinical picture of PE is nonspecific in pregnancy. It is associated with significant mortality in the absence of therapy. Thrombolysis has been utilized frequently with positive results.


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