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首页> 外文期刊>Sri Lanka Journal of Forensic Medicine, Science & Law >Medicolegal aspects of Maternal Deaths due to Pulmonary Thromboembolism
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Medicolegal aspects of Maternal Deaths due to Pulmonary Thromboembolism

机译:肺血栓栓塞致孕产妇死亡的法医学方面

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A state of hypercoagulability protects pregnant women from bleeding tendency which leads to pulmonary thromboembolism and results in medicolegal issues. Case 01 32 year old pregnant female who developed weakness of legs, and was suspected to have Spinal Tuberculosis. Lower Segment Caesarian Section was performed and Heparin was started as she was immobile. Vertebral surgery was performed and anticoagulants were stopped. She died due to sudden onset difficulty of breathing. Allegations of medical negligence were raised by the relatives at the autopsy. The autopsy revealed bilateral Deep Vein Thrombosis (DVT) and pulmonary embolism. Case 02 A mother who presented with a first trimester abortion and pain in right leg died following sudden onset shortness of breath. She also had a history of a previous first trimester abortion. Autopsy revealed an embolus in the pulmonary artery with swollen and congested right leg without DVT. CONCLUSIONS Case 01 Regarding the allegations of medical negligence, the legal authorities will consider whether the discontinuation of prophylactic anticoagulants before the 2nd surgery was a necessity and whether it was for the best interest of the patient. Case 02 Immunological syndromes and inherited thrombophilia could be considered as underlying causes for multiple first trimester abortions and Deep Vein Thrombosis. The Importance of performing the risk assessment of DVT when indicated is highlighted.
机译:高凝状态可保护孕妇免于流血的趋势,这会导致肺血栓栓塞并导致法医学问题。病例01 32岁的孕妇腿部无力,被怀疑患有脊椎结核。进行了下段剖腹产手术,肝素因无法移动而开始使用肝素。进行椎骨手术并停止抗凝剂治疗。她因突然呼吸困难而死亡。亲属在尸检时提出医疗过失的指控。尸检显示双侧深静脉血栓形成(DVT)和肺栓塞。病例02一位母亲在妊娠早期发生了流产和右腿疼痛,在突然出现呼吸急促后死亡。她还曾有过早孕流产史。尸检显示肺动脉栓塞,右腿肿胀充血,无DVT。结论案例01关于医疗过失的指控,法律当局将考虑是否有必要在第二次手术前停用预防性抗凝剂,以及是否出于患者的最大利益。病例02免疫综合症和遗传性血栓形成可能被认为是导致多个早孕流产和深静脉血栓形成的根本原因。突出显示了执行DVT风险评估的重要性。

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