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Massive hemorrhage following thrombolysis for postpartum pulmonary embolism with cardiac arrest.

AbstractBACKGROUND:
Cardiac arrest following a massive pulmonary embolism in pregnancy or the puerperium is a rare and catastrophic event.
CASE:
We describe a case of massive pulmonary embolism with cardiac arrest in a 36-year-old patient, presenting 48 hours postpartum. She was treated with thrombolytic therapy and suffered a massive hemorrhage thereafter, which was compounded by disseminated intravascular coagulation. Following an emergency hysterectomy and massive blood-product transfusion, she survived with no neurological sequelae. The medical team present had participated in two simulation sessions with similar scenarios in the weeks before the event.
CONCLUSION:
To our knowledge, this is only the fifth case reported in the literature on thrombolytic therapy in the postpartum period, and of these has the most severe hemorrhagic complication. An effective multidisciplinary approach to such a complex situation can be acquired through simulation-based training.
AuthorsTalya Shaulov, Michèle David, Marieve Pellerin, Francine Morin
JournalJournal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC (J Obstet Gynaecol Can) Vol. 36 Issue 6 Pg. 498-501 (Jun 2014) ISSN: 1701-2163 [Print] Netherlands
PMID24927187 (Publication Type: Case Reports, Journal Article)
Topics
  • Adult
  • Female
  • Heart Arrest (complications)
  • Hemorrhage (chemically induced)
  • Humans
  • Puerperal Disorders (drug therapy)
  • Pulmonary Embolism (complications, drug therapy)
  • Severity of Illness Index
  • Thrombolytic Therapy (adverse effects)

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