Top

Published in:

01-12-2017 | Clinical Report

Pre-eclampsia and acute pulmonary embolism—the importance of making a differential diagnosis: a case report

Authors: R. Suthar, S. Abdelfattah, H. Goldman, G. Garcia, D. Romero-Fischmann, M. Escobar, V. Behrens

Published in: Journal of Anesthesia | Issue 6/2017

Abstract

We describe the case of a 41-year-old pregnant patient who presented at 38 weeks of gestation for an urgent cesarean section, with new onset of pre-eclampsia as the initial diagnosis. The intraoperative course was complicated by seizures and hemodynamic collapse. Initially, the presentation of seizure pointed to pre-eclampsia/eclampsia; however, with careful consideration of each event as it occurred, the correct diagnosis was later determined to be pulmonary embolism and stroke. This case illustrates the importance of considering multiple possible etiologies, even when a particular diagnosis seems obvious.

Donnelly JC, D’Alton ME. Pulmonary embolus in pregnancy. Semin Perinatol. 2013;37(4):225–33.CrossRefPubMed

Turner JA. Diagnosis and management of pre-eclampsia: an update. Int J Womens Health. 2010;30(2):327–37.CrossRef

James MR, Phyllis AA, George B, John RB, Ira MB, Maurice D, Robert RG, Joey PG, Arun J, Donna DJ, Ananth KS, Marshall DL, Michelle YO, George RS, Baha MS, Catherine YS, Eleni T, James NM. American College of Obstetricians and Gynecologists Staff. In: Hypertension in Pregnancy. Washington, DC: The American College of Obstetricians and Gynecologists; 2013.

Beach Robert L, Kaplany Peter W. Seizures in pregnancy: diagnosis and management. Int Rev Neurobiol. 2008;83:259–71.CrossRefPubMed

Donaldson JO, Lee NS. Arterial and venous stroke associated with pregnancy. Neurol Clin. 1994;12(3):583–99.PubMed

Webster MW, Chancellor AM, Smith HJ, Swift DL, Sharpe DN, Bass NM, Glasgow GL. Patent foramen ovale in young stroke patients. Lancet. 1988;2(8601):11–2.CrossRefPubMed

Hart LA, Sibai BM. Seizures in pregnancy: epilepsy, eclampsia, and stroke. Semin Perinatol. 2013;37(4):207–24.CrossRefPubMed

James AH. Pregnancy-associated thrombosis. Hematol Am Soc Hematol Educ Progr. 2009;2009:277–85.

Stone SE, Morris TA. Pulmonary embolism during and after pregnancy. Crit Care Med. 2005;33(10 suppl):S294–300.CrossRefPubMed

10.

Farzi F, Abdollahzadeh M, Faraji R, Chavoushi T. Seizure in pregnancy following cerebral venous sinus thrombosis. Anesthesiol Pain Med. 2015;5(3):e26866.CrossRef

11.

Aoki S, Kobayashi N, Mochimaru A, Takahashi T, Hirahara F. Seizures associated with lupus during pregnancy. Clin Case Rep. 2016;4(4):366–8.CrossRefPubMedPubMedCentral

Title: Pre-eclampsia and acute pulmonary embolism—the importance of making a differential diagnosis: a case report
Authors: R. Suthar
S. Abdelfattah
H. Goldman
G. Garcia
D. Romero-Fischmann
M. Escobar
V. Behrens
Publication date: 01-12-2017
Publisher: Springer Japan
Published in: Journal of Anesthesia / Issue 6/2017
Print ISSN: 0913-8668
Electronic ISSN: 1438-8359
DOI: https://doi.org/10.1007/s00540-017-2396-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Pre-eclampsia and acute pulmonary embolism—the importance of making a differential diagnosis: a case report

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 6/2017

Effects of short-term exposure to sevoflurane on the survival, proliferation, apoptosis, and differentiation of neural precursor cells derived from human embryonic stem cells

Is use of glycine-containing drugs in anesthesia safe?

Airway spray efficacy of local anesthetic with fiberscope

Anesthesia research in Japan: seeds of recovery and the role of the Journal of Anesthesia

Endotracheal intubation: ultrasound-guided versus fiberscope in patients with cervical spine immobilization

Effect of swallowing maneuver on fentanyl-induced coughing