Effect of Early Anticoagulation in Post Partum Deep Venous Thrombosis as a Preventive Measure for Pulmonary Embolism -Case Report

Abstract

Background: Deep vein thrombosis (DVT) is a serious complication occasionally seen during pregnancy and puerperium. Incidence of DVT is approximately 1 in 1000-2000 pregnancies. Pulmonary embolism arising from deep vein thrombosis is one of the important causes of maternal mortality. Objectives: To demonstrate the effectiveness of early anticoagulation in management of deep vein thrombosis in a post-partum and in prevention of pulmonary embolism. Method: 35-year-old female who presented to the facility after being discharged a week later after successful delivery. Patient was admitted with exertional dyspnea, palpitation, bilateral leg swelling, syncope, orthopnea and elevated levels of blood pressure. Provisional diagnosis of Post partum deep vein thrombosis with possible pulmonary embolism was made. Bilateral doppler ultrasound confirmed the presence of deep vein thrombosis (DVT) of the left leg. Transthoracic echocardiography (TTE) was done and showed normal cardiac functions and structure with ejection fraction of 83 percent. Computed tomography pulmonary angiogram (CTPA) confirmed absence of the PE with small bilateral pleural effusion. The patient was anticoagulated with low molecular weight heparin and clinical and hemodynamic response was excellent with no maternal hemorrhagic complications. Data was analyzed using images before and after the intervention. Results: Anticoagulation is a rapid and life-saving therapeutic measure reducing the risk of developing pulmonary embolism and shortens hospital stay and post-partum mothers should be initiated as soon as possible when the diagnosis of DVT has been made. Conclusion: Deep vein thrombosis in postpartum complicating pulmonary embolism (PE) carries a high mortality rate.