Obstet Gynecol Sci.  2014 Jul;57(4):260-265. 10.5468/ogs.2014.57.4.260.

Pregnancy-associated pulmonary embolism during the peripartum period: An 8-year experience at a single center

• Lee MY
• Kim MY
• Han JY
• Park JB
• Lee KS
• Ryu HM

• KMID: 1841536
• DOI: http://doi.org/10.5468/ogs.2014.57.4.260

Abstract

OBJECTIVE
The purpose of this study was to estimate the incidence, timing of onset, risk factors, and mortality rate of pregnancy-associated pulmonary embolism (PAPE).
METHODS
We analyzed PAPE cases that occurred between January 2005 and December 2012 at Cheil General Hospital & Women's Healthcare Center. Those cases that were not confirmed by computed tomography scan or were confirmed as amniotic fuid embolisms were excluded. We analyzed various risk factors such as previous surgery, mode of delivery, maternal age, and obesity in PAPE.
RESULTS
There were 57,092 deliveries over 8 years. Of them, 13 cases (0.023%) were diagnosed with PAPE. All cases occurred in the postpartum period after cesarean delivery. There were no cases of PAPE after vaginal deliveries. Of the total cases, 10 cases (76.9%) were diagnosed in the early postpartum period within 48 hours. Eight cases (61.5%) had a history of previous surgery. There were 3 cases (23.1%) of multiple pregnancy and 3 cases (23.1%) of preterm delivery. No cases had a history of venous thromboembolism. Among 13 cases, 10 cases improved with only anticoagulation, 2 cases received surgical thrombectomy, and one case was maternal death.
CONCLUSION
Our results indicated that the incidence of PAPE was very low (0.023%) and occurred mainly in the postpartum period after cesarean section. However, its maternal mortality rate was significantly high (7.7%). Therefore, we suggest that immediate diagnosis and prompt treatment should be prioritized for improvement of PAPE patients' survival rate.

Keyword

Peripartum period; Pregnancy; Pulmonary; Thromboembolism

MeSH Terms

Cesarean Section
Delivery of Health Care
Diagnosis
Embolism
Female
Hospitals, General
Incidence
Maternal Age
Maternal Death
Maternal Mortality
Mortality
Obesity
Peripartum Period*
Postpartum Period
Pregnancy
Pregnancy, Multiple
Pulmonary Embolism*
Risk Factors
Survival Rate
Thrombectomy
Thromboembolism
Venous Thromboembolism

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