Acute Pulmonary Embolism During Pregnancy and Puerperium: National Trends and In-Hospital Outcomes

Islam Y. Elgendy, Mohamed M. Gad, Hend Mansoor, Ahmed N. Mahmoud, Ayman Elbadawi, Anas Saad, Marwan Saad, Ahmed Elkaryoni, Eric A. Secemsky, Mamas A. Mamas, Manuel Monreal, Ido Weinberg, Carl J. Pepine

Research output: Contribution to journalArticlepeer-review


Objective: To investigate the trend and outcomes of acute pulmonary embolism (PE) during pregnancy and puerperium using a large national database. Patients and Methods: The National Inpatient Sample was queried to identify pregnancy-related hospitalizations in the United States from January 1, 2007, through September 30, 2015. Temporal trends in the rates of acute PE and in-hospital mortality rates were extracted. Results: Among 37,524,314 hospitalizations, 6,333 patients (0.02%) had acute PE. The prevalence of comorbidities and risk factors such as hypertension, obesity, and smoking increased, but rates of acute PE did not change significantly (18.01 in 2007 vs 19.36 in 2015, per 100,000 hospitalizations, Ptrends=.21). Advanced therapies were used in a small number of women (systemic thrombolysis: 2.4%, surgical pulmonary embolectomy: 0.5%, and inferior vena cava filter in 8.3%). Rates of in-hospital mortality were almost 200-fold higher among those who had acute PE (29.3 vs 0.13, per 1000 pregnancy-related, P<.001). The rate of in-hospital mortality did not change among women with acute PE (2.6% in 2007 vs 2.5% in 2015, Ptrends=.74). Conclusion: In this contemporary analysis of pregnancy-related hospitalizations, acute PE was uncommon, but rates have not decreased over the past decade. Acute PE during pregnancy and puerperium was associated with high maternal mortality, and the rates of in-hospital mortality have not improved. Future studies to improve prevention and management of acute PE during pregnancy and puerperium are warranted.

Original languageEnglish
Pages (from-to)2102-2113
Number of pages12
JournalMayo Clinic Proceedings
Issue number8
StatePublished - Aug 2021

Bibliographical note

Funding Information:
Drs Elgendy and Gad contributed equally to this work. Grant Support: The authors report no funding for this article.

Publisher Copyright:
© 2021

ASJC Scopus subject areas

  • Medicine (all)


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