Expanding outpatient management of low-risk pulmonary embolism to the pregnant population: a case series
Abstract
Abstract Background Outpatient treatment of pregnant patients with acute pulmonary embolism (PE) is recommended by some obstetric and haematology societies but has not been described in the literature. Little is known about patient selection and clinical outcomes. Case summary We report two cases of pregnant patients diagnosed with acute PE. The first, at 9 weeks of gestational age, presented to the emergency department with 12 h of pleuritic chest pain and was diagnosed with segmental PE. She was normotensive and tachycardic without evidence of right ventricular dysfunction. She received multispecialty evaluation, was deemed suitable for outpatient management, and, after 12 h of monitoring, was discharged home on enoxaparin with close follow-up. The second case, at 30 weeks of gestational age, presented to obstetrics clinic with 3 days of dyspnoea. Vital signs were normal except for tachycardia. She was referred to labour and delivery, where she was diagnosed with segmental PE. Her vital signs were stable, and she had no evidence of right ventricular dysfunction. After 6 h of monitoring, she was discharged home on enoxaparin with close follow-up. Neither patient developed antenatal complications from their PE or its treatment. Discussion This case series is the first to our knowledge to describe patient and treatment characteristics of pregnant patients with acute PE cared for as outpatients. We propose a definition for this phenomenon and discuss the benefits of and…
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Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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