[Fulminant pulmonary embolism in the 35th gestational week. Sonographic detection of a thrombus in the inferior vena cava with normal cavography].
Pulmonary embolism is the most common cause of maternal death during pregnancy. CASE REPORT. We report a 28-year-old obstetric patient (35th gestational week) who was admitted to the hospital because of intermittent vaginal bleeding caused by placenta totalis et accreta. Eleven days after admission she suffered a cardiac arrest. After cardiopulmonary resuscitation, an emergency caesarian section was performed and a healthy child was delivered. Abdominal sonography (B-mode) showed a floating thrombus in the inferior vena cava. Perfusion scintigraphy and cavography were normal; a computed tomography i.v. contrast medium study confirmed the presence of the thrombus. An open thrombectomy was performed to protect the patient from further pulmonary emboli. After 8 days she left the intensive care unit without residual complications. CONCLUSION. This case emphasises the importance of bedside sonography as a diagnostic method of identifying the source of a thrombus in patients with suspected pulmonary embolism.
Kilger
E
E
Institut für Anästhesiologie, Klinikum Grosshadern der Ludwig-Maximilians-Universität München.
Anthuber
C
C
Berger
H
H
Jauch
K W
KW
Polasek
J
J
Briegel
J
J
Haller
M
M
D000328:Adult; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications; D011655:Pulmonary Embolism / Q000209:etiology*; D013927:Thrombosis / Q000150:complications* / Q000000981:diagnostic imaging; D014463:Ultrasonography; D014682:Vena Cava, Inferior
Fulminante Lungenembolie in der 35. SSW. Sonographischer Nachweis eines Thrombus in der V. Cava inferior bei unauffälligem Kavographiebefund.