///2009 Abstract Details
2009 Abstract Details2018-05-01T17:45:11+00:00

PREGNANT WOMAN WITH EXTENSIVE DEEP VENOUS THROMBOSIS AT THE SAME TIME OF LABOR. USING OR NOT USING THE VENA CAVA FILTER COULD BE CONSIDERED AS A REASONABLE DOUBT

Abstract Number: 253
Abstract Type: Case Report/Case Series

EUGENIO FERNANDEZ DOCTOR1 ; Nuria Dueas Resident2; Ana Villafranca Resident3; Lourdes Bermejo Staff Anesthesiologist4; Marisol Perea Staff Anesthesiologist5; Beatriz Amoros Staff Anesthesiologist6

A Caesarean section (C-Section) always requires an extra effort to the anaesthesiologist due to the risk to mother and fetus. In the case presented below, the C-Section became more complicated than usual because of the femoral Deep Venous Thrombosis (DVT).

This case is exceptional because DVT was at the same time of labor and the risk of a Pulmonary Embolism (PE) conditioned the work of the anaesthesiologist in every moment.

A 31 year-old woman with no significant past medical history, and in her first pregnancy. She suffered an extensive DVT in her left leg; diagnosis was performed by clinic and compression ultrasonography evaluation. Unfractioned heparin was prescribed. After interconsultation with other medical services, the decision to keep a fourty hour moderate treatment with Anticoagulation therapy, so as to stabilize the thrombosis, and diminish the risk of a PE and the C-Section was taken. Twenty four hours after admission, the patient went into labor. The course of action taken was to stop the heparin pump; 1.5h afterwards, under general anaesthesia with rapid sequence induction, the C-Section procedure was done. The procedure occurred without any incident or increase bleeding; two hours later, following the hematology recommendations, unfractioned heparin was reintroduced. The postoperative went on without further complications, at the present time the patient is under thrombophilia screening.

Conclusions: We took a different approach, which differs from the traditional medical procedure to follow. We did not use a vena cava filter and, we reintroduced heparin two hours after the C-Section was conducted, in spite of guidelines because of the emergency situation. Our procedure was supported by reviews on the current topic and professional experience, ending with great resolve. We think that our experience could help other professionals in this situation.



SOAP 2009