Management of Acute Saddle Pulmonary Embolism in Pregnancy Following Fetal Surgery

Cureus. 2024 Feb 21;16(2):e54607. doi: 10.7759/cureus.54607. eCollection 2024 Feb.

Abstract

A 33-year-old gravidity three parity three (G3P3) woman at 34 weeks of pregnancy underwent fetal surgery to repair an open lumbosacral myelomeningocele at 22 weeks gestation and experienced preterm premature rupture of membranes as a result. She developed a saddle pulmonary embolus with signs of right heart strain while on prolonged bed rest. She was treated emergently with aspiration thrombectomy and suprarenal inferior vena cava (IVC) filter placement, followed by an uncomplicated cesarean delivery thereafter.

Keywords: anticoagulation; bleeding in pregnancy; critical care obstetrics; fetal surgery; high-risk pregnancy; intravenous thrombolytic therapy; ivc thrombus; massive pulmonary embolism; pulmonary embolism; therapeutic anticoagulation.

Publication types

  • Case Reports