FULMINANT PULMONARY-EMBOLISM IN AN OBSTET RIC PATIENT - SONOGRAPHIC PROOF OF A THROMBUS IN THE INFERIOR VENA-CAVA WITH NORMAL CAVOGRAPHY

Pulmonary embolism is the most common cause of maternal death during p regnancy. Case report. We report a 28-year-old obstetric patient (35th gestational week) who was admitted to the hospital because of intermi ttent vaginal bleeding caused by placenta totalis et accreta. Eleven d ays after admission she suffered a cardiac arrest. After cardiopulmona ry resuscitation, an emergency caesarian section was performed and a h ealthy child was delivered. Abdominal sonography (B-mode) showed a flo ating thrombus in the inferior vena cava. Perfusion scintigraphy and c avography were normal; a computed tomography i.v. contrast medium stud y confirmed the presence of the thrombus. An open thrombectomy was per formed to protect the patient from further pulmonary emboli. After 8 d ays she left the intensive care unit without residual complications. C onclusion. This case emphasises the importance of bedside sonography a s a diagnostic method of identifying the source of a thrombus in patie nts with suspected pulmonary embolism.