Postpartum Pulmonary Embolism in a Grand Multiparous: A Case Report

Area of Science:

• Obstetrics and Gynecology
• Critical Care Medicine
• Thrombosis Research

Background:

• Venous thromboembolism (VTE) is a significant cause of maternal morbidity and mortality.
• Antenatal VTE risk assessment is crucial for identifying high-risk pregnancies.
• Limited antenatal care may increase the risk of undiagnosed or untreated VTE.

Observation:

• A 38-year-old grand multiparous woman presented with a VTE risk score of 2, not receiving thromboprophylaxis.
• Four hours postpartum, she suffered cardiac arrest due to pulmonary embolism.
• Disseminated intravascular coagulation and multiorgan failure followed, leading to death.

Findings:

• A fatal pulmonary embolism occurred despite a low antenatal VTE risk score.
• Postpartum timing of VTE can be rapid and catastrophic.
• Multifactorial risk assessment, including lifestyle and recent infections, is vital.

Implications:

• VTE risk assessment in pregnancy requires careful consideration of all contributing factors.
• Enhanced vigilance for VTE is necessary, especially in patients with limited antenatal visits.
• Timely thromboprophylaxis and prompt management are critical for improving maternal outcomes in VTE.