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Obstetrics & Gynecology 2005;106:1153-1155
© 2005 by The American College of Obstetricians and Gynecologists
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CASE REPORTS

Postcesarean Pulmonary Embolism, Sustained Cardiopulmonary Resuscitation, Embolectomy, and Near-Death Experience

Alan T. Marty, MD1, Frank L. Hilton, MD2, Robert K. Spear, MD3 and Bruce Greyson, MD4

From the Departments of 1Cardiac Surgery, 2Obstetrics and Gynecology, and 3Pulmonary Medicine, Saint Mary’s Medical Center, Evansville, Indiana, and the 4Department of Psychiatric Medicine, Division of Personality Studies, University of Virginia, Charlottesville, Virginia.

BACKGROUND: Survival after surgical embolectomy for massive postcesarean pulmonary embolism causing sustained cardiac arrest is rare.

CASE: One day after an uneventful cesarean delivery, a woman developed cardiac asystole and apnea due to pulmonary embolism. Femoral-femoral cardiopulmonary bypass performed during continuous cardiopulmonary resuscitation allowed a successful embolectomy. Upon awakening, the patient reported a near-death experience. Pulmonary embolism causes approximately 2 deaths per 100,000 live births per year in the United States, and postcesarean pulmonary embolism is probably more common than pulmonary embolism after vaginal delivery.

CONCLUSION: Massive pulmonary embolism is a potentially treatable catastrophic event after cesarean delivery, even if continuous cardiopulmonary resuscitation is required until life-saving embolectomy is done.




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