Challenging Retrieval of a Migrated Peripheral Venous Cannula Fragment in an Obstetric Patient: Case Report

Intravenous cannulation is a routine procedure in clinical practice but may rarely be complicated by catheter fracture with intravascular fragment retention. Management is particularly challenging in obstetric patients, where both maternal safety and procedural risks must be carefully balanced. We report the case of a 31-year-old pregnant woman at 21 weeks of gestation admitted for conservative management of preterm prelabor rupture of membranes. Three days after peripheral intravenous catheter placement in the right cephalic vein, catheter fracture with intravascular retention of a fragment was identified. Ultrasound localized the fragment within the cephalic vein, with subsequent migration to the deltopectoral groove. An initial surgical exploration was unsuccessful. Following repeat ultrasound localization, a second surgical procedure performed by an experienced vascular surgeon enabled successful retrieval using a Fogarty catheter. Cephalic vein ligation was performed to prevent further migration. The procedure was completed without complications, and the pregnancy progressed for an additional nine weeks, culminating in preterm delivery of a viable neonate. This case highlights the importance of accurate localization, the need for a stepwise surgical approach after failed initial intervention, and the role of vascular expertise in achieving successful outcomes in complex obstetric patients.