PO0047 - Life threatening thromboembolic event associated to pregnancy in an adolescent woman

Background: Pregnancy and the puerperium are well-established risk factors for venous thromboembolism (VTE), a disease that includes pulmonary embolism (PE) and deep venous thrombosis (DVT). Pregnant women are 4 to 5 times more likely to develop venous thromboembolism than women who are not. Approximately 30% of apparently isolated episodes of PE are associated with silent DVT and in patients presenting with symptoms of DVT, the incidence of silent PE ranges from 40–50%.

Aims: PE is the leading cause of maternal death in the developed world. Besides death, venous thromboembolism can cause significant acute and chronic morbidity. Delayed diagnosis, delayed or inadequate treatment and inadequate thromboprophylaxis account for many of these deaths. This presentation aims to raise awareness of increased risk of VTE during the postpartum period even in adolescent women.

Methods: Presentation of a case report of a 17 years old woman with a pulmonary embolism. Review of the literature with estimation of frequency of adolescent women with postpartum venous thrombotic event.

Results: A 17-year-old young woman admitted 27 days after delivery of her first child for 10 days of progressive dyspnea, cough and hemoptysis.
Laboratory testing proved high inflammatory values, anemia, thrombocytosis, antithrombin deficiency, increased levels of factor VIII and homocysteine. Angio CT confirmed bilateral embolization and dilatation of the right heart and bilateral pleural effusion. Cardiac examination proved with signs of mild pulmonary hypertension. Anticoagulant treatment of LMWH was introduced, which was later changed to dabigatran. Thrombolytic treatment was not indicated. Molecular genetic testing of antithrombin deficiency is underway.

Conclusion(s): Among pregnant women, the highest risk period for venous thromboembolism and pulmonary embolism in particular is during the postpartum period. Any prophylaxis against these events should be particularly targeted to postpartum women.