A 22-year-old woman with an uncomplicated pregnancy develops sudden dyspnea with cyanosis and hypotension intrapartum during routine vaginal delivery of a term infant. She has a generalized seizure and becomes comatose. Her condition does not improve over the next 2 days. Which of the following findings is most likely to be present in her peripheral pulmonary arteries?
High-Yield Explanation
Amniotic fluid embolism rarely occurs in pregnancy, but it has a high mortality rate. The fluid reaches torn uterine veins through ruptured fetal membranes. Aggregates of platelets represent localized thrombosis, an unlikely event in the lungs. Fat globules are seen in fat embolism, usually after severe trauma. Gas bubbles in vessels from air embolism can be a rare event in some obstetric procedures, but it is an unlikely event in natural deliveries. Peripheral pulmonary thromboemboli are most likely to produce chronic pulmonary hypertension and develop over weeks to months.