Peripartum pulmonary embolism: Anesthetic and surgical considerations
Peripartum pulmonary embolism: Anesthetic and surgical considerations作者机构：Department of Anesthesia Hamad Medical Corporation Weil Cornell Medical College Doha Qatar Department of OBGY Hamad Medical Corporation Doha Qatar
出 版 物：《Open Journal of Obstetrics and Gynecology》 (妇产科期刊（英文）)
年 卷 期：2013年第3卷第1期
页 面：158-164页
学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学]
主 题：Peripartum Pulmonary Embolism Computerized Tomographic Pulmonary Angiography Low Molecular Weight Heparin
摘 要：Pregnancy and peripartum period leads to Virchow’s triad (hypercoagulability, venous stasis and vascular injury) thereby increasing the risk of thromboembolism by many folds in these patients. Accurate diagnosis of peripartum pulmonary embolism is pertinent for reducing morbidity and mortality. Accurate diagnosis is also vital for avoiding the adverse effects of unwanted anticoagulation in pregnant mother and fetus in a patient wrongly diagnosed with this condition. Computerized tomographic pulmonary angiography has a high specificity and sensitivity in comparison to ventilation/perfusion scan for diagnosis of peripartum pulmonary embolism (PPE). It has a lower fetal radiation exposure and aids in arriving at an alternative diagnosis, if PPE is absent. Low molecular weight heparin is the medication of choice in the treatment of peripartum pulmonary embolism. Thrombolysis is considered in patients with massive PPE and hemodynamic instability, refractory hypoxia or right ventricular dysfunction. Regional anesthesia/analgesia can be given safely in these patients. We report two cases of PPE and review the anesthetic and surgical consideration.
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