What is the treatment of pulmonary embolism during pregnancy

The treatment of combined pulmonary embolism in pregnancy should fully consider the effects of anticoagulant drugs on the pregnant woman and the fetus. In case of general patients, the combination of low molecular heparin and warfarin is chosen for anticoagulation, but warfarin has teratogenic effect on the fetus, so subcutaneous injection of low molecular heparin is preferred for maternal pulmonary embolism and the applied dose is adjusted according to maternal weight. If warfarin is used in early pregnancy, it can cause central nervous system abnormalities in the fetus, with a risk of teratogenicity, and in late pregnancy, it can cause fetal or neonatal hemorrhage or placental abruption. Other anticoagulants, including sodium fondaparinux or Bactrim, lack evidence in the treatment of pulmonary embolism in pregnancy, so subcutaneous injection of low molecular heparin is chosen for the treatment of pulmonary embolism in pregnancy for at least 3 months. Some mothers have delivered during the course, and because warfarin is not metabolized by breast milk, warfarin can be given as overlapping anticoagulation therapy after delivery. Once anticoagulation is achieved, the use of low molecular heparin is discontinued and warfarin alone is used for anticoagulation, which is maintained for at least 6 weeks postpartum, with an overall anticoagulation duration of no less than 3 months. Other anticoagulants, including sulforaphane sodium and rivaroxaban, are inadequately based in maternal use.