Pulmonary Embolism And Blood Clots
Pulmonary embolism is a condition in which an artery in the lung contains a blood clot that stops blood flow. It often occurs during or soon after labor and delivery. Pulmonary embolisms can threaten the life of the mother if they are not diagnosed and treated immediately.
Although among developed countries pulmonary embolism is a leading cause of maternal death, the U.S. itself has one of the highest maternal death rates of all industrialized nations. Pulmonary embolism is responsible for 20 percent of maternal deaths in the U.S. each year.
Risk Factors Associated With Pulmonary Embolism In Women During Pregnancy
Pregnant women who have a history of varicose veins, blood clots or deep vein thrombosis are at elevated risk for developing pulmonary embolism.
The level of obesity of the pregnant mother can present a major risk factor for developing pulmonary embolism as well. Pregnant women with a BMI greater than 30 are at elevated risk to acquire the condition.
Another factor contributing to the development of pulmonary embolism is irritable bowel syndrome, which itself enhances the likelihood of developing blood clots.
Cesarean section deliveries and twin pregnancies can also elevate the risk, but this risk can be diminished with proper management.
Diagnosis And Symptoms Of Pulmonary Embolism In Women
Many times it is difficult to detect pulmonary embolism in pregnant women due to the fact that their circulatory system is altered to a significant degree throughout pregnancy. Some of the symptoms that accompany pregnancy in general are also symptoms of pulmonary embolism. These include chest pain, shortness of breath, and swelling of the legs.
In order to properly assess if a patient has pulmonary embolism, obstetricians generally focus on reviewing the patient’s general health and medical history. The patient is then put through various tests to verify the presence of a blood clot, including blood tests and diagnostic imaging tests (MRI, CT or ultrasound). Failure to do so could constitute negligence.
In many cases, the evidence of pulmonary embolism manifests very clearly. Symptoms can include rapid pulse, anxiety, sharp chest pain, intense sweating, and shortness of breath. The condition is so serious that in less than 30 minutes of symptoms appearing, brain damage can occur. Immediate recognition and treatment of pulmonary embolism are critical in order to prevent or minimize damage, or even save the patient’s life and the life of the baby when the woman is pregnant.
Treatment And Prevention Of Pulmonary Embolism In Mothers
Generally, pregnant women diagnosed with pulmonary embolism are given heparin, a blood thinner that inhibits the blood’s ability to clot. In certain critical scenarios, the patient may be given thrombolytics to break up existing blood clots. The purpose of anticoagulant drugs is to stop any existing blood clots from growing larger and prevent new ones from forming. The most common anticoagulant drug given is warfarin, but its maximum effectiveness occurs after a few days — therefore, heparin is usually given to patients to ensure more immediate results.
Doctors may prescribe warfarin to women over a period of several months until the blood clot has completely dissolved. Compression stockings may also be added as another element of treatment.
Anticoagulants also have a side effect that must be considered. Patients that receive an open wound while taking anticoagulants may find it extremely difficult to stop the bleeding. Hospitals must exercise caution when prescribing anticoagulants to patients.
For women who are pregnant or who have just given birth, one or more of the following steps are sometimes taken to help avoid the occurrence of blood clots:
- The mother is given compression socks to wear during a cesarean section birth. The compression helps prevent the formation of blood clots.
- After cesarean section birth, the mother is given heparin and encouraged to get up and walk around ASAP to promote blood flow.
- The mother with a BMI over 40 is given heparin after she delivers the child
Patients with blood clots before and after pregnancy may be subjected to a long process of treatment in order to eventually resolve the issue. Unlike other conditions that require emergency intervention and provide a quick solution, addressing a blood clot with anti-coagulation drugs may take as long as six months or more until the issue and health concerns are finally resolved. Sometimes the patient may be given longer-term treatment because of the risks they possess.
Compensation For Losses Incurred Due To Pulmonary Embolism
Patients who have had pulmonary embolism often require long-term care. They may need specialized equipment, future surgeries, and even a personal health assistant to address their needs. This long-term care can become very expensive. If your condition of pulmonary embolism was incorrectly diagnosed, treated or managed, you have the right to hold those responsible who failed in their duty of care, and obtain the compensation you need to recover from your losses.