Peripartum Pulmonary Embolism [chapter]

Nissar Shaikh, Firdous Ummunnisa, Arshad Chanda, Umm-e-Amara, Mohammed A. Imran, Mahammad Zubair, Jazib Hassan, Mohammad Nayeemmuddin, Qazi Zeeshan, Zia Mahmood, Saher Thaseen, Abdul Gafoor Tharayil (+3 others)
2019 Embolic Diseases - Evolving Diagnostic and Management Approaches [Working Title]  
Pregnancy and peripartum increase the risk of venous thromboembolism (VTE) by many folds. Interestingly, the VTE is more common during the pregnancy, whereas the pulmonary embolism is more frequent in postpartum period. There are various risk factors for the VTE and pulmonary embolism in these patients. The important risks are improper thromboprophylaxis, obesity, and multigravida. The clinical parameters and the d-dimer are not used for diagnosis of thromboembolism during pregnancy and in the
more » ... ostpartum period. The compression ultrasonography (CUSG) is commonly used for VTE diagnosis; for the pulmonary embolism diagnosis, one has to consider the radiation hazard to the fetus as well as to the mothers. Ventilation/perfusion scan is the imaging of choice for patient who has respiratory signs with normal chest radiograph. If chest X-ray is abnormal with suspicion of peripartum pulmonary embolism (PPE), the choice should be computed tomographic angiography. Heparin and its derivatives remained the anticoagulation of choice for the treatment of VTE as well as the PPE, as it is a shorter acting, easy to reverse with protamine sulfate. Proper thromboprophylaxis is the key for prevention of VTE and peripartum pulmonary embolism.
doi:10.5772/intechopen.84688 fatcat:4qder3wn2na5zcii6ogkamt2eu