Abstract

ROJAS-SANCHEZ, Antonio Gerardo; NAVARRO-DE LA ROSA, Gabriela; MIJANGOS-MENDEZ, Julio César  and  CAMPOS-CERDA, Ricardo. Pulmonary thromboembolism in pregnancy and the puerperium. Neumol. cir. torax [online]. 2014, vol.73, n.1, pp.42-48. ISSN 0028-3746.

The pregnant woman has five times greater the risk of developing pulmonary thromboembolism with respect to non-pregnant, mainly due to the cardiovascular and coagulation changes characteristic of pregnancy, and the risk increases with the presence of other factors such as age, previous pulmonary embolism, systemic lupus erythematosus and multiparity, among others. The diagnostic process begins with clinical suspicion. Determination of D-dimer is useful because its negative predictive value. The helical computed tomography has a high sensitivity and specificity in the diagnosis of pulmonary thromboembolism, while pulmonary angiography remains the definitive diagnostic study. Treatment consists of anticoagulation as soon as the diagnosis is established, both unfractionated heparin and low molecular weight heparins are the drugs of choice over vitamin K antagonists, primarily because the first ones do not cross the placental barrier, and have fewer side effects due to their short half-life.

Keywords : Pulmonary thromboembolism; pregnancy; puerperium; venous thromboembolic disease; deep vein thrombosis.