JCMC doctors save pregnant woman suffering from pulmonary embolism
Jul 15, 2012 | 2415 views | 0 0 comments | 18 18 recommendations | email to a friend | print

feeling chest pains and experiencing a shortage of breath and difficulty breathing. She was rushed by her family to Hoboken University Medical Center, where doctors performed a CAT scan that revealed a clot in her lung, and was immediately transferred to the Intensive Care Unit at Jersey City Medical Center. Here, an echocardiogram revealed that the 29-year-old Hoboken woman was in imminent danger of dying from a pulmonary embolism. An estimated 60,000 deaths are caused annually by this condition.

“The patient was extremely short of breath and very anxious; we couldn’t even get her to lie down at first,” said Dr. Andrew Novick, an interventional radiologist who saw Rodriguez that afternoon in the hospital’s interventional radiology suite with a team of Jersey City Medical Center doctors that included Dr. Pragresh Gadhvi, an interventional cardiologist; Dr. David Flores, a pulmonary specialist; and Dr. David Principe, a high risk pregnancy specialist.

Fortunately, Dr. Novick had prior expertise with the EKOS Thrombolysis System, a device that offers a minimally invasive treatment for patients with DVT. However there is little data on the best method to treat a pregnant woman suffering from a pulmonary embolism.

“We were in unchartered territory,” he admitted.

Other treatment options, said Dr. Novick, would have included either giving the patient massive doses of tPA, which can cause bleeding, raising the chances the woman could lose the baby; using a more aggressive device that sucks the clot out but also increases patient risk; or chest surgery to remove the clot directly. Additionally, while anticoagulants can help prevent more clot build up, they do not dissolve the blood clot itself.

Dr. Novick and the physician team elected to perform Ekos Thrombolysis, threading catheters from the groin into each pulmonary artery, dispensing one to two milligrams of tPA hourly – compared to the 100 milligrams which might have been given if she had not been pregnant. Ultrasound pulses, working the medication into the clot, acted quickly.

The patient was monitored closely in the ICU by Drs. Flores and Gadhvi, and by morning, the patient was already sitting up and feeling much better.

Ten weeks later, Rodriguez returned to Jersey City Medical Center, this time to deliver a healthy daughter, Zamyiah. Today, both mother and baby are doing fine.

“This could have been a disaster,” said Dr. Novick. “But thanks to our team approach, it turned out well.”

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