Multidisciplinary team approach on massive postpartum pulmonary thromboembolism: experience from three cases

Thromboembolic events are one of the leading causes of maternal death during the postpartum period. In developed countries, the maternal death rate due to thromboembolic events is 1.34 per 100,000 live births, accounting for 14.9% of all maternal deaths (1). The incidence of pulmonary thromboembolism (PTE), a serious clinical condition that results in death of the mother either during pregnancy or the peripartum period, was reported as 1 in 1,000–3,000 pregnancies, and PTE is the leading cause of maternal death, with a rate of about 5%, in industrialized countries (2-4). A Maternal death exploratory committee in Japan reported that 13 out of 213 maternal deaths between 2010 and 2012 were due to pulmonary embolism (5). In a Korean single-center report, there were 13 cases of pulmonary embolism out of a total of 57,092 deliveries over an eight-year period. The authors stated that all cases occurred during the postpartum period after delivery with Cesarean section (C/S) and that ten patients were diagnosed during the early postpartum period within the first 48 hours of delivery. Of these 13 patients, ten improved with only anticoagulation therapy, whereas two patients received surgical thrombectomy, and one patient died (6)