Pulmonary Embolism in Pregnancy

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It is a blockage, usually a blood clot that prevents oxygen from reaching the tissues of the lungs; it  can be life-threatening 

Diagnostic Criteria 

  • Acute onset of shortness of breath (dyspnea)
  • Pleuritic chest pain
  • Cough and/or hemoptysis
  • Low grade fever
  • Tachypnea
  • Diminished oxygen saturation
  • Diminished breath sounds

Investigations 

  • Venous Doppler ultrasound 
  • Pulmonary angiography 

  • CT scan, MRI  

  • D-dimer 

Non-pharmacological Treatment 

Respiratory support and Oxygen supplementation 

Pharmacological Treatment 

B:    unfractionated heparin (UFH) is the treatment of choice Loading dose 150 U/kg (or minimum of 5000 U) followed by   Initial infusion 15–25 U/kg/hour (or minimum of 1000U/hourly) 

Note: Check PTT every 4 hours and adjust infusion to maintained PTT at 1.5–2.5 x control. Once steady  state has been achieved measure PTT levels daily. Change heparin to SC route after 5–10 days to  avoid formation of hematoma. 

Referral: Immediate  referral  to  a  health  facility  where  expertise  and  monitoring  of  the  treatment  through  laboratory tests is available is recommended.