Journal List > J Korean Soc Echocardiogr > v.6(1) > 1075267

J Korean Soc Echocardiogr. 1998 Jul;6(1):100-105. Korean.
Published online July 31, 1998.  https://doi.org/10.4250/jkse.1998.6.1.100
Copyright © 1998 Korean Society of Echocardiography
Two Cases of Acute Pulmonary Embolism After Cesarean Section Confirmed by Echocardiography
Woo Shik Kim, Jin Man Cho, Heung Sun Kang, Chung Whee Choue, Kwon Sam Kim, Jung Sang Song and Jong Hoa Bae
Division of Cardiology, Department of Internal Medicine, Kyung Hee University, School of Medicine, Seoul, Korea.
Abstract

In the past 60 years the maternal mortality rate has declined rnarkedly. Nevertheless, death associated with childbirth is still a major public health problem. For women delivered of live infants, the leading causes of mortality are acute pulmonary embolism(mostly thromboembolic), pregnancy-induced hypertension, hemorrhage, and infection. Currently, the common cause of maternal rnortality are pulmonary embolisrn. Though acute pulmonary embolism is a potentially fatal disorder, when properly diagnosed and treated, clinically apparent pulmonary embolism was an uncommon cause of death. However, the diagnosis of acute pulmonary embolism is still a challenge for clinicians because of its nonspecific and variable clinical features. Pulmonary angiography, admittedly the 'gold standard' technique for this diagnosis, is costly, invasive, and not universally available. Noninvasive procedures such as lung scan has certainly simplified the diagnostic approach. However, lung scan is diagnostic in only 30 to 50% of patients, and many institutions lack nuclear medicine facilities. Thus, alternative imaging techniques are needed for the noninvasive diagnosis of pulmonary embolism. Echocradiography is rapid, practical and sensitive technique for the identification of right ventricular overload following acute pulmonary embolism. Echocardiographic identification of patients with right ventricular dysfunction is important because aggressive intervention with thrombolytics, certain inotropic and vasoactive agents, or embolectomy may improve outcome. We report herein two cases of acute pulmonary embolism after cesarean section. Certain clinical findings, hemodynamic values, and particularly, echocardiographic signs can indentify right ventricular dysfunction after pulmonary embolisrn. The patients was immediately treated mth intravenous heparin and inotropic support, which induced a rapid improvement of the clinical and hemodynamic parameters.

Keywords: Acute pulmonary embolism; Cesarean section; Echocardiography

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