Postcesarean Pulmonary Embolism, Sustained Cardiopulmonary Resuscitation, Embolectomy, and Near-Death Experience

Survival after surgical removal of a massive blood clot from the lungs (embolectomy) following a cesarean delivery that causes sustained cardiac arrest is rare. In this case, a woman went into cardiac arrest and stopped breathing one day after an uncomplicated cesarean due to a pulmonary embolism. While continuous cardiopulmonary resuscitation was performed, doctors used a heart-lung machine connected to the leg vessels to allow successful removal of the clot. After waking, the patient reported a near-death experience. Pulmonary embolism causes about 2 deaths per 100,000 live births per year in the United States, and it is probably more common after cesarean than vaginal delivery. Massive pulmonary embolism after cesarean delivery can be treated even if continuous CPR is needed until embolectomy.

Study at a glance

Abstract

BACKGROUND: Survival after surgical embolectomy for massive postcesarean pulmonary embolism causing sustained cardiac arrest is rare. CASE: One day after an uneventful cesarean delivery, a woman developed cardiac asystole and apnea due to pulmonary embolism. Femoral-femoral cardiopulmonary bypass performed during continuous cardiopulmonary resuscitation allowed a successful embolectomy. Upon awakening, the patient reported a near-death experience. Pulmonary embolism causes approximately 2 deaths per 100,000 live births per year in the United States, and postcesarean pulmonary embolism is probably more common than pulmonary embolism after vaginal delivery. CONCLUSION: Massive pulmonary embolism is a potentially treatable catastrophic event after cesarean delivery, even if continuous cardiopulmonary resuscitation is required until life-saving embolectomy is done.