Why is a post op C-section patient at high risk for pulmonary embolism?

Why is a post op C-section patient at high risk for pulmonary embolism?

• A. Regular ambulation after surgery
• B. Abdominal surgery increases risk
• C. Low platelets decrease risk
• D. Adequate hydration increases risk

Answer: (B)

This question centers on how pregnancy and surgery increase the chance of a blood clot traveling to the lungs. Pregnancy creates a hypercoagulable state, and a cesarean section is major abdominal surgery that causes endothelial injury and promotes venous stasis due to postoperative pain and limited mobility. Put together, these factors meet Virchow’s triad and markedly raise the risk of deep vein thrombosis and pulmonary embolism after a C-section. The idea that regular ambulation would increase risk is incorrect—ambulation actually reduces risk by improving venous return. Low platelets don’t increase PE risk (they tend to reduce clot formation and raise bleeding risk), and adequate hydration lowers, not raises, clot risk by decreasing blood viscosity.

This question centers on how pregnancy and surgery increase the chance of a blood clot traveling to the lungs. Pregnancy creates a hypercoagulable state, and a cesarean section is major abdominal surgery that causes endothelial injury and promotes venous stasis due to postoperative pain and limited mobility. Put together, these factors meet Virchow’s triad and markedly raise the risk of deep vein thrombosis and pulmonary embolism after a C-section. The idea that regular ambulation would increase risk is incorrect—ambulation actually reduces risk by improving venous return. Low platelets don’t increase PE risk (they tend to reduce clot formation and raise bleeding risk), and adequate hydration lowers, not raises, clot risk by decreasing blood viscosity.