[Fulminant pulmonary embolism in the 35th gestational week. Sonographic detection of a thrombus in the inferior vena cava with normal cavography]

Anaesthesist. 1993 Jun;42(6):388-90.
[Article in German]

Abstract

Pulmonary embolism is the most common cause of maternal death during pregnancy. CASE REPORT. We report a 28-year-old obstetric patient (35th gestational week) who was admitted to the hospital because of intermittent vaginal bleeding caused by placenta totalis et accreta. Eleven days after admission she suffered a cardiac arrest. After cardiopulmonary resuscitation, an emergency caesarian section was performed and a healthy child was delivered. Abdominal sonography (B-mode) showed a floating thrombus in the inferior vena cava. Perfusion scintigraphy and cavography were normal; a computed tomography i.v. contrast medium study confirmed the presence of the thrombus. An open thrombectomy was performed to protect the patient from further pulmonary emboli. After 8 days she left the intensive care unit without residual complications. CONCLUSION. This case emphasises the importance of bedside sonography as a diagnostic method of identifying the source of a thrombus in patients with suspected pulmonary embolism.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Female
  • Humans
  • Pregnancy
  • Pregnancy Complications*
  • Pulmonary Embolism / etiology*
  • Thrombosis / complications*
  • Thrombosis / diagnostic imaging
  • Ultrasonography
  • Vena Cava, Inferior*