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Journal of Obstrectic Anaesthesia and Critical Care
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Year : 2012  |  Volume : 2  |  Issue : 1  |  Page : 38-39

Successful thrombolysis of right heart emboli-in-transit causing cardiac arrest during caesarean section

Department of Obstetrics and Gynaecology, Worcestershire Royal Hospital, United Kingdom

Correspondence Address:
Supriya Bulchandani
7 Coleford Close, Webheath, Redditch, B97 5UX Worcestershire
United Kingdom
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2249-4472.99319

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We report a rare case of successful thrombolysis of right heart emboli-in-transit causing cardiac arrest, during caesarean section in a 42-year-old primigravida. This was diagnosed by intra-operative echocardiography. Return to spontaneous circulation was achieved. This was followed by massive post-partum haemorrhage managed conservatively. The lady was discharged home with a Greenfield Inferior Vena Caval filter and Warfarin. Systemic thrombolytic therapy is a challenging decision to make but is usually recommended if it is not contraindicated and the thrombi are demonstrated in more than one cardiac chamber, entailing a higher risk of surgical intervention. However, the potential for massive obstetric bleeding and further side effects must be considered and adequate strategies and resources should be available.

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