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Case Report

Inherited Thrombophilia as a Cause of Post-Partum Massive Pulmonary Embolism: A Case Report

Kamal Preet Palta, Yash Krishna, Bibhash Roy, Mahima Nautiyal

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Indian Journal of Emergency Medicine 12(3):p 162-168, July - Sept. 2026. | DOI: https://doi.org/10.21088/ijem.2395.311X.12326.8

How Cite This Article:

Yash Krishna, Kamal Preet Palta, Bibhash Roy et. al, Inherited Thrombophilia as a Cause of Post-Partum Massive Pulmonary Embolism: A Case Report. Ind J Emerg Med. 2026; 12(3): 162-168.

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Received : February 24, 2026         Accepted : March 26, 2026          Published : September 30, 2026

Abstract

Introduction: Pulmonary embolism (PE) is a life-threatening manifestation of venous thromboembolism (VTE) and remains one of the leading causes of maternal morbidity and mortality worldwide. The post-partum period is associated with a heightened hypercoagulable state, which may be further amplified by inherited thrombophilia such as protein S deficiency. Early recognition is challenging due to the non-specific clinical presentation and the overlap of symptoms with physiological post-partum changes. Case Report: We report the case of a 28-year-old female who presented to the emergency department in an unconscious state following sudden collapse, 15 days after an uncomplicated lower segment caesarean section. The patient had a preceding history of unilateral leg pain. Initial resuscitation was successful, and subsequent investigations revealed massive pulmonary embolism with right ventricular strain. Laboratory evaluation demonstrated markedly elevated D-dimer levels and significantly reduced free protein S levels, consistent with protein S deficiency. The patient was managed with systemic thrombolysis followed by intensive care support and long-term anticoagulation. Conclusion: Pulmonary embolism should be considered in all post-partum patients presenting with sudden collapse or unexplained hemodynamic instability. Early diagnosis, prompt thrombolytic therapy in appropriate cases, and evaluation for underlying thrombophilia are essential to reduce mortality and guide longterm management strategies. Key Message: • Pulmonary embolism is a catastrophic yet potentially reversible cause of sudden collapse in post-partum patients. • In young individuals with massive PE, inherited thrombophilia such as protein S deficiency should be actively investigated, as identification significantly influences acute management, duration of anticoagulation, and future pregnancy counselling

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Data Sharing Statement

There are no additional data available. All raw data and code are available upon request.

Funding

This research received no funding.

Author Contributions

All authors contributed significantly to the work and approve its publication.

Ethics Declaration

This article does not involve any human or animal subjects, and therefore does not require ethics approval.

Acknowledgements

We would like to express our gratitude to the patients, their families, and all those who have contributed to this study.

Conflicts of Interest

No conflicts of interest in this work.

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Cite this article

Yash Krishna, Kamal Preet Palta, Bibhash Roy et. al, Inherited Thrombophilia as a Cause of Post-Partum Massive Pulmonary Embolism: A Case Report. Ind J Emerg Med. 2026; 12(3): 162-168.

Licence:

Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)

This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.

Received Accepted Published
February 24, 2026 March 26, 2026 September 30, 2026
DOI: https://doi.org/10.21088/ijem.2395.311X.12326.8

Keywords

Pulmonary EmbolismProtein S DeficiencyPost-PartumVenous ThromboembolismThrombolysisEmergency Medicine

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Timeline

Received February 24, 2026
Accepted March 26, 2026
Published September 30, 2026

licence

Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)

This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.


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