"After my pulmonary embolism, I thought I might not see my daughter again"
The birth of a new baby should be a magical time for new parents, but for Natasha, a young South African woman, the dream turned into a nightmare two days after the safe delivery of her daughter by Caesarian section.
While still in the hospital, Natasha suffered a pulmonary embolism, or PE, a potentially life-threatening condition caused by a blood clot getting trapped in the lungs and blocking blood flow in the pulmonary artery that feeds the heart. If not recognized and treated promptly, a PE can lead to long-term damage to the function of the heart, heart attack and even death.
Why pregnant women and new mothers are at greater risk of pulmonary embolism
A PE usually originates as a clot (or thrombus) that forms in the leg as a deep-vein thrombosis (DVT) before being carried to the lungs in the bloodstream. While these rogue blood clots most commonly occur in people over 601, there are certain situations that increase the risk of them forming in younger age groups; airline travel is perhaps the best known of these. Less well-known are the risks associated with pregnancy and the first few weeks after giving birth, but, in fact, PE is a leading cause of maternal mortality in the developed world.2,3
A variety of factors combine to create this risk – the main one being that as soon as a woman becomes pregnant, the make-up of her blood starts to change, increasing its ability to clot quickly in order to minimize the amount of blood she will lose during childbirth. However, the relative risk of an unwanted, dangerous clot spontaneously forming in the venous circulation also increases; in the few weeks after childbirth, this risk is approximately 20-fold higher than for a woman of the same age who has not just had a baby.4
In Natasha’s case, the fact her daughter had been delivered by Caesarian – a surgical procedure – would have further increased the need for her blood to clot to help her heal, making her risk of PE even higher.
Struggling to breathe after giving birth
Natasha had just been discharged from the hospital when she collapsed in the bathroom there.
“It started off with feeling a bit faint, like I was about to collapse,” she recalls. That day, she’d woken up feeling as if “someone was sitting on my chest, making it hard to breathe.”
She was given oxygen and moved to the critical care department, where she received intravenous anticoagulation (blood-thinning) drugs and closely monitored. However, it soon became clear that Natasha was not responding to this treatment, with regular echocardiograms showing that the strain on her heart was increasing due to the compromised blood supply.
Given this deterioration, her doctors organized for her to undergo an emergency procedure using a specialist device that had only recently been introduced to the hospital.
The EKOS™ Acoustic Thrombolysis System is a minimally invasive, non-surgical system for dissolving thrombus. It uses an innovative catheter and transducer to simultaneously deliver ultrasonic waves and a thrombolytic, “clot-busting” drug directly into the PE. The acoustic field created by the ultrasound unwinds and thins out the dense, tangled mesh of fibrin that forms the clot, speeding up the distribution and penetration of the thrombolytic drug, and significantly reducing the time it takes to work.
“I was really nervous going in,” Natasha admits. “I had prepared myself for the worst, thinking that I might not see my daughter again.”
A new lease on life with her family
But in the end, EKOS made all the difference. Within a few hours, Natasha's vital signs and the strain on her heart were showing improvement.
“I remember waking up and feeling like I could actually breathe,” she says. “I immediately felt as if the weight had been taken off my chest and I was out of the danger zone.”
Natasha was able to return home within a few days and has been able to enjoy spending time with her daughter and husband as she regains full fitness.
“Today, I’m feeling much better, nearly 100 percent,” she says. “I have a new lease on life, knowing it was nearly taken away from me, and I wouldn’t have had all those moments with my daughter.”
Find about the latest Boston Scientific advancements in thrombosis.
Belohlavek J et al. Pulmonary embolism, part I: Epidemiology, risk factors and risk stratification, pathophysiology, clinical presentation, diagnosis and nonthrombotic pulmonary embolism. Exp Clin Cardiol. 2013; 18(2): 129–138
Rossignol M et al. Maternal mortality due to venous thromboembolism in France 2013–2015. Gynécologie Obstétrique Fertilité & Sénologie 2021; 49(1): 67-72
Hobohm L et al. Fatality rates and use of systemic thrombolysis in pregnant women with pulmonary embolism. ESC Heart Failure 2020; 7: 2365–2372
Thrombosis and Embolism during Pregnancy and the Puerperium: Acute Management (Green-top Guideline No. 37b). Royal College of Obstetricians and Gynaecologists (RCOG) 2015.