Severe Hemodynamic Instability in a Young Pregnant Woman with Massive Pericardial Effusion and Pulmonary Embolism Secondary to Primary Mediastinal Non-Hodgkin’s Lymphoma

Journal of Clinical Medicine, Journal Year: 2025, Volume and Issue: 14(8), P. 2670 - 2670

Published: April 14, 2025

Background: Lymphomas account for approximately 10% of cancers diagnosed during pregnancy, with Hodgkin’s lymphoma being the most common. However, non-Hodgkin lymphomas, including primary mediastinal large B-cell (PMBCL), also represent a significant proportion. Both lymphomas and pregnancy develop hypercoagulable state, increasing risk venous thromboembolism massive pulmonary embolism (PE), requiring extracorporeal membrane oxygenation (ECMO). Methods: Clinical data, blood test imagings have been collected by medical records patient. Results: We present 25-year-old woman, at 32 weeks gestation, who presented to emergency department progressive dyspnea asthenia. Echocardiography revealed hemodynamically pericardial effusion severe right ventricular dysfunction. Given severity her condition, she underwent an caesarean section subsequently drainage. A chest computed tomography scan incidental mass along PE. Despite drainage, remained unstable. Since thrombolysis was contraindicated recent cesarean section, venoarterial ECMO initiated. Systemic anticoagulation guaranteed heparin, which shifted argatroban heparin resistance. The biopsied, diagnosis PMBCL carried out. Cytoreductive chemotherapy initiated COMP-R regimen (i.e., cyclophosphamide, vincristine, methotrexate, prednisone, rituximab), patient progressively improved up ICU hospital discharge. Conclusions: This case highlights challenges in managing complicated early multidisciplinary intervention, crucial stabilizing optimizing fetal maternal prognosis.

Language: Английский

Intraoperative PEEP Individualization: From Basic to Advanced Techniques

Current anesthesiology reports, Journal Year: 2024, Volume and Issue: 14(4), P. 525 - 533

Published: Aug. 24, 2024

Language: Английский