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massive pumloanry embolus

massive pumloanry embolus Posted by Mark D.
dear dr paul,
if a patient is in early labour and collapses and a massive pulmoary thrombus or amniotic fluid embolus is highly suspected then what should be our plan regarding delivering the baby? particularly if she needs ventillation then should we plan a CS before that ? she will be needed unfractionated heparin so it will
cause bleeding during CS . pl guide us.
Posted by PAUL A.
You follow the guidelines for maternal resuscitation. If there is cardiac arrest, then you undertake a perimortem CS at 4 minutes. Even if she has not arrested, it may be appropriate to undertake a grade I CS ad part of maternal resuscitation. Issues about future need for heparin are not relevent. The alternative is letting her die.
Posted by clarice M.
Question 12 from EMQ mock test:
A 32 year old woman with severe pre-eclampsia has had an emergency caesarean section at 32 weeks gestation because of IUGR. She became hypotensive and tachycardic and was returned to theatre where 2l of blood was evacuated from the abdomen and hysterectomy was performed. Three days later, she developed sudden onset severe chest pain and breathlessness and dies despite resuscitation

My answer: Pulmonary embolus (option F)
Correct answer: Thromboembolism (option N)
Explanation given: Sudden onset chest pain after major surgery in pregnancy = PE until proven otherwise

Is this a fault to do with me, the options provided or the explanation?