Case Report: Aviation Pulmonary Embolism in Pregnancy

Abstract

This case report discusses an expanding demographic: Aviation-related venothromboembolism (VTE) in pregnancy. As the number of commercial flights increase and the notion of travel gains popularity, the obstetrician is certain to meet an increasing number of at-risk mothers bound for a long haul flight. The pregnancy state itself being hypercoaguable, studies show that air-travel specific conditions namely immobility, dehydration and hypobaria which leads to
thrombus formation. Despite VTE being a leading cause of maternal mortality in world wide, specific preventive protocols regarding the at-risk pregnant flier remain scarce-to-nil. Data has shown that compressive stockings alone remain insufficient. The much-debated role of injectable thromboprophylaxis pre-flight is discussed here. Data and studies regarding oral anticoagulants for prevention and treatment of VTE are fast rising and their roles in pregnancy explored. In summation, evidence irrevocably shows that the risks of VTE outweigh that of bleeding. However, the imperative for thromboprophylaxis in at risk pregnant fliers is still controversial.