Thrombolysis After Emergency Cesarean Section in Sickle Cell Disease

Abstract

Pulmonary embolism (PE) is a rare complication during pregnancy. However, it is still the leading cause of morbidity and mortality. The risk to develop a PE is even higher in patients suffering from an inherited blood disorder like sickle cell disease (SCD). We report on the management of a 28-year-old woman with SCD who was admitted to the hospital with painful sickle cell crisis and developed a massive PE followed by cardiac arrest. The patient could be revived and underwent thrombolysis successfully with recombinant tissue plasminogen activator (r-tPA) 22 h after emergency cesarean section without complications related to thrombolysis. However, she developed an acute kidney injury and transient liver dysfunction which both improved gradually during her course. Finally, she was extubated on the 16th postoperative day and transferred to the obstetric ward on the 21st postoperative day. The patient recovered completely and was discharged home without neurological deficit.

J Clin Gynecol Obstet. 2020;9(4):124-128
doi: https://doi.org/10.14740/jcgo668