title: Extensive pulmonary embolism after severe postpartum haemorrhage: management with an inferior vena cava filter.
abstract: We report the case of a 36-year-old woman with an inferior vena cava thrombosis and extensive pulmonary embolism six days after a severe postpartum haemorrhage. She had undergone caesarean section with bleeding managed by massive transfusion, hysterectomy, and two attempts at uterine artery embolization. Systemic thrombolysis and catheter-directed thrombolysis in intensive care were abandoned due to recent and incomplete uterine artery embolization. A temporary inferior vena cava filter was chosen because of significant risk of massive pulmonary embolism. This was a controversial decision because guidelines from different professional groups offer conflicting recommendations. The therapeutic options for the management of massive postpartum pulmonary embolism when thrombolysis is contraindicated are discussed.
authors.affiliation: Service d'Anesthésie-Réanimation, Hôpital de Hautepierre, Strasbourg, France. Electronic address: bilgeraudrey@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Bilger
authors.affiliation: Service d'Anesthésie-Réanimation, Hôpital de Hautepierre, Strasbourg, France.
authors.forename: J
authors.initials: J
authors.lastname: Pottecher
authors.affiliation: Service d'Anesthésie-Réanimation, Hôpital de Hautepierre, Strasbourg, France.
authors.forename: M
authors.initials: M
authors.lastname: Greget
authors.affiliation: Service d'Anesthésie-Réanimation, Hôpital de Hautepierre, Strasbourg, France.
authors.forename: E
authors.initials: E
authors.lastname: Boudier
authors.affiliation: Service d'Anesthésie-Réanimation, Hôpital de Hautepierre, Strasbourg, France.
authors.forename: P
authors.initials: P
authors.lastname: Diemunsch
mesh_terms: D000328:Adult; D001803:Blood Transfusion; D002585:Cesarean Section / Q000009:adverse effects; D002779:Cholestasis; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D007044:Hysterectomy; D006473:Postpartum Hemorrhage / Q000628:therapy*; D011247:Pregnancy; D011655:Pulmonary Embolism / Q000209:etiology* / Q000628:therapy*; D015912:Thrombolytic Therapy; D016896:Treatment Outcome; D016306:Vena Cava Filters; D014682:Vena Cava, Inferior
keywords: IVC filter; Inferior vena cava thrombus; Pregnancy; Pulmonary embolism