Open Access Emergency Medicine (Jun 2023)
Pulmonary Thromboembolism in Pregnancy: A Case Report and Literature Review
Abstract
Gustavo Andrés Urriago-Osorio,1,2 Luis Álvaro Melo-Burbano,1,2 Juanita López-Van Den Berghe,2 Angela María Muñoz-Córdoba,2 Jorge Enrique Daza-Arana,1,3 Eduardo Contreras-Zúñiga2 1Department of Health, Internal Medicine Specialization Program, Universidad Santiago de Cali, Santiago de Cali, Colombia; 2Emergency Department, Clínica de Occidente S.A, Santiago de Cali, Colombia; 3Health and Movement Research Group, Universidad Santiago de Cali, Santiago de Cali, ColombiaCorrespondence: Gustavo Andrés Urriago-Osorio, Department of Health, Internal Medicine Specialization Program, Universidad Santiago de Cali, Cl. 5 #No. 62 − 00, Pampalinda, Santiago de Cali, Valle del Cauca, 760035, Colombia, Tel +57 3163029030, Email gustavo.urriago00@usc.edu.coAbstract: Data on the optimal diagnostic management of pregnant women with suspected pulmonary embolism are limited. Despite a lack of compelling evidence in some practices, clinical practice guidelines focus on the management of these patients. We present the case of a 24-year-old patient at 36 weeks of pregnancy in whom pulmonary thromboembolism (PTE) was diagnosed in a timely manner also with hemodynamic instability and echocardiographic images with clear involvement of the right cavities. She received thrombolytic therapy with alteplase 100 mg intravenously over 2 hours, which resulted in excellent outcomes for both the pregnant woman and fetus. Understanding the acute approach and management of these patients will improve our clinical practice; therefore, we reviewed a case report of a pregnant patient with high-risk PTE and compared it with current evidence. In conclusion, PE is a common disease with a high mortality rate during pregnancy. Therefore, having made a timely diagnosis using the relevant diagnostic aids and performing thrombolysis with rtPA increase the probability of survival in our patient, leading to successful results for both her and the fetus.Keywords: pulmonary embolism, venous thromboembolism, pregnancy, thrombolysis, fibrinolytics