Pulmonary emboli originate from deep vein thrombi which occur frequently in pregnancies, prolonged bed-ridden state, cardiac diseases, cerebrovascular diseases, etc.. The authors analyzed 10 cases of sudden unexplained deaths and found that 4 cases of them probably had pulmonary embolism as a cause of deterioration and death. The estimated pulmonary embolism-related operative mortality was 0.1-0.3% according to the degree of suspicion. Most of the natural course of the disease are rapidly progressive ones and it is sometimes very difficult and impractical to obtain a definite diagnosis due to rapid deterioration and /or sudden death before studies. So the recognition of predisposing factors and prevention in risky patients are stressed.
Causality ; Death, Sudden ; Diagnosis ; Female ; Heart Diseases ; Humans ; Mortality* ; Pregnancy ; Pregnancy, Prolonged ; Pulmonary Embolism* ; Veins ; Venous Thrombosis

This study was done to evaluate transvaginal ultrasonographic measurement of cervical length at 20 to 24 weeks and 37 weeks as a predictor of prolonged pregnancy (defined as a pregnancy that extended beyond 41+2 weeks of gestation [289 days]) in nulliparous women. This prospective observational study enrolled 149 consecutive nulliparous women with singleton gestation at 37 weeks. Cervical length was measured by transvaginal ultrasonography at 20 to 24 weeks and 37 weeks. Cervical length at 37 weeks, but not at 20 to 24 weeks, was significantly longer in women delivered at >41+2 weeks than in those delivered at < or =41+2 weeks (p<0.005). There was a significant correlation between cervical length at 37 weeks and gestational age at delivery (Pearson correlation coefficient, r=0.387, p<0.0001). In the receiver operating curve, the best cut-off value of cervical length at 37 weeks for the prediction of prolonged pregnancy was 30 mm, with a sensitivity of 78% and a specificity of 62%. Cervical length assessed by transvaginal ultrasonography at 37 weeks can predict the likelihood of prolonged pregnancy in nulliparous women. However, there is no association between cervical length at 20 to 24 weeks and the occurrence of prolonged pregnancy.
Vagina ; ROC Curve ; Prospective Studies ; Pregnancy, Prolonged/*diagnosis ; Pregnancy ; Humans ; Gestational Age ; Female ; Cervix Uteri/*anatomy & histology/*ultrasonography ; Adult