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Pooja Choradia: Recognizing Pulmonary Embolism in Pregnancy Before It Is Too Late
Pooja Choradia/Instagram
Apr 15, 2026, 14:39

Pooja Choradia: Recognizing Pulmonary Embolism in Pregnancy Before It Is Too Late

Pooja Choradia, Critical Care Associate at P.D. Hinduja Hospital Khar, shared a post on LinkedIn:

“Pregnancy and Pulmonary Embolism

A Silent Threat That Needs Early Recognition

Pregnancy is a beautiful journey—but it also brings physiological changes that increase the risk of blood clots, including pulmonary embolism (PE), one of the leading causes of maternal morbidity and mortality.

Why is pregnancy a hypercoagulable state?

During pregnancy, the body naturally prepares to prevent excessive bleeding during delivery.

This leads to:

  • Increased clotting factors (fibrinogen, factors VII, VIII, X)
  • Reduced natural anticoagulants
  • Decreased fibrinolysis
  • Venous stasis due to enlarged uterus compressing veins

Result: Higher risk of deep vein thrombosis (DVT) and PE

When is the risk highest?

  • Third trimester
  • Immediate postpartum period (first 6 weeks)
  • After cesarean delivery

Risk factors to watch

  • Previous history of DVT/PE
  • Obesity
  • Prolonged immobilization (bed rest, travel)
  • Thrombophilia (inherited/acquired)
  • Age more than 35 years
  • Smoking
  • Multiple pregnancy
  • IVF pregnancies

Symptoms of pulmonary embolism

Symptoms can be subtle and often overlap with normal pregnancy changes—making diagnosis tricky.

Look out for:

  • Sudden breathlessness
  • Chest pain (sharp, pleuritic)
  • Rapid heart rate
  • Cough (sometimes with blood)
  • Unexplained anxiety or dizziness

Red flag: Sudden unexplained breathlessness should Never be ignored in pregnancy.

Diagnosis challenges

D-dimer is often elevated in pregnancy – less reliable.

Imaging may be required:

  • CT Pulmonary Angiography (CTPA)
  • V/Q scan

Risk of radiation is low and diagnosis should not be delayed

Management

Low molecular weight heparin (LMWH) is the treatment of choice.

  • Safe in pregnancy (does NOT cross placenta)

Warfarin is avoided during pregnancy.

Anticoagulation usually continued for:

  • At least 3 months
  • And 6 weeks postpartum

Prevention is key

High-risk women may need:

  • Prophylactic LMWH
  • Early mobilization
  • Hydration
  • Compression stockings

Take-home message

  • Pregnancy increases clot risk – but awareness saves lives
  • Breathlessness is not always ‘normal’ in pregnancy
  • Early diagnosis plus timely treatment equals excellent outcomes

Clinical insight

Pulmonary embolism in pregnancy is often underdiagnosed due to symptom overlap.

Maintaining a high index of suspicion is crucial for every clinician.”

Pooja Choradia: Recognizing Pulmonary Embolism in Pregnancy Before It Is Too Late

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deep vein thrombosis DVT Health Hematology Hemostasis Hemostasis News Hemostasis Today Hypercoagulability Medicine Pooja Choradia Pregnancy Pulmonary embolism thrombosis
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