Pulmonary Embolism During Pregnancy and the Postpartum Period: Incidence, Intensive Care Management and Outcome

Abstract

Objective: Pregnant people pose some challenge to the intensivists and their management is clinically important in the intensive care unit (ICU). Thrombotic events and pulmonary embolism (PE) is one of the most important causes of maternal morbidity and mortality. The aim of this study is to evaluate the incidence, diagnostic approaches, therapeutic interventions, intensive care management and outcome of parturient admitted to obstetric intensive care which were suspected to have PE. Materials and Methods: In this study, all pregnant or postpartum women with the sign or symptoms of PE which admitted to obstetric ICU of Alzahra teaching hospital during 5 years were reviewed. Demographic data, clinical signs or symptoms, diagnostic approaches, patient management and final outcome of the patients were collected, noted and analyzed. Results: Totally 200 parturient with the suspicion to have PE were admitted to ICU during 5 years. Mean age, weight and height of patients were 26.61 +/- 4.28 years, 75.24 +/- 3.06 kg and 157.87 +/- 7.89 cm, respectively. 136 (68%) patients were assessed carefully with imaging techniques and pulmonary emboli PE was ruled out in 124 (62%) patients whose CT was normal and 76 (38%) revealed unilateral (59 patients) or bilateral (8 patients) PE. Mean admission time was 7 days and overall mortality was 2.6% (2 patients). Conclusion: PE is an important cause of pregnancy-related mortality and morbidity and can mimic many other clinical conditions. However, high index of suspicion, accurate diagnostic approaches and timely prophylaxis and therapy can prevent maternal mortality.