Puerperous pulmonary thromboembolism: Incidence, clinical features, treatment and outcome, study of 13 cases

Objective 　To explore the clinical features, treatment and outcome of puerperium pulmonary thromboembolism (PTE). Methods 　To count the cases of spontaneous labor and cesarean section, as well as the incidence of PTE, treated in the First Affiliated Hospital of Guangzhou Medical University from Jan. 2006 to Nov. 2011, and retrospectively analyze the data of hospitalized parturients with PTE. Results 　A total of 5052 cases of spontaneous delivery were collected at the obstetric ward, of which 2910 cases (57.6%) were cesarean sections and 2142 cases (42.4%) were vaginal delivery. On the duration of hospital stay, 13 cases (0.26%) were diagnosed as puerperal PTE by CT pulmonary angiography, of which 11 cases occurred within 3 days after delivery. The incidence of puerperal PTE was significantly higher in cases with cesarean section than in those with vaginal delivery (0.38% vs0.09%, P=0.043). The most common symptoms of puerperal PTE were breathless (76.9%), cough (53.8%), pleuritic chest pain (23.1%) and fever (30.8%). The clinical symptoms were improved by anticoagulation therapy (11 cases) or thrombolysis (2 cases) with zero mortality. Conclusions 　The incidence of puerperal PTE in the hospital the authors served is 0.26%. Puerperal PTE should be considered especially to those parturients with sudden dyspnea, chest tightness or pleuritic chest pain within 3 days after cesarean section.