FULMINANTE LUNGENEMBOLIE IN DER 35. SSW. SONOGRAPHISCHER NACHWEIS EINES THROMBUS IN DER V. CAVA INFERIOR BEI UNAUFFALLIGEM KAVOGRAPHIEBEFUND

Pulmonary embolism is the most common cause of maternal death during pregnancy. Case report. We report a 28-year-old obstetric patient (35th gestational week) who was admitted to the hospital because of intermittent vaginal bleeding caused by placenta totalis et accreta. Eleven days after admission she suffered a cardiac arrest. After cardiopulmonary resuscitation, an emergency caesarian section was performed and a healthy child was delivered. Abdominal sonography (B-mode) showed a floating thrombus in the inferior vena cava. Perfusion scintigraphy and cavography were normal; a computed tomography i.v. contrast medium study confirmed the presence of the thrombus. An open thrombectomy was performed to protect the patient from further pulmonary emboli. After 8 days she left the intensive care unit without residual complications. Conclusion. This case emphasises the importance of bedside sonography as a diagnostic method of identifying the source of a thrombus in patients with suspected pulmonary embolism.