Pregnancy and pulmonary embolism; a fatal challenge: literature review

Pulmonary embolism, as a relatively common non-obstetrics complication, is an important cause of maternal mortality during pregnancy. Due to some physiological and hormonal changes, the risk of pulmonary embolism increases during pregnancy and postpartum. This review article was performed with aim to explore the last articles related to diagnostic methods and treatment of this disease.  

In this review article, databases of Google scholar, PubMed, Embase, Medline, Iranmedex and IranDoc were systematically searched using the keywords of pulmonary embolism, thromboembolism, pregnancy, anticoagulant, thrombolytic and thrombectomy during 1990 to 2021.

In this review article, finally 62 studies regarding pathophysiology, clinical feature, diagnostic strategies and treatment of pulmonary embolism during pregnancy were investigated.

The diagnosis of pulmonary embolism during pregnancy needs a high clinical suspicious. Due to the dangers of ionizing radiation to the fetus, correct using of diagnostic algorithms can reduce diminish radiation exposure to mother and fetus. Use of injectable anticoagulants such as enoxaparin is the main treatment method of pulmonary embolism during pregnancy. Oral anticoagulants are not recommended in pregnant women. Also, thrombolytic therapy and surgical thrombectomy can be used in the case of massive and life threatening pulmonary embolism.