Signs and Symptoms of Pulmonary Embolism in Pregnant Women: What You Need to Know

Pulmonary embolism (PE) is a serious and potentially life-threatening condition that can affect anyone, but it poses unique risks during pregnancy. While the general symptoms of PE are similar across populations, pregnant women face additional physiological changes and risk factors that can complicate diagnosis and treatment. Beyond the typical venous thromboembolism caused by blood clots, expectant mothers may also be vulnerable to rare but dangerous forms such as amniotic fluid embolism, air embolism, or even fat embolism—particularly during surgical procedures or in cases of maternal obesity. Recognizing the signs early is crucial for timely intervention and better outcomes.

Common Symptoms of Pulmonary Embolism During Pregnancy

Pregnancy naturally alters cardiovascular and respiratory function, making it harder to distinguish between normal discomfort and warning signs of a serious condition like PE. However, certain symptoms should never be ignored, especially when they appear suddenly or worsen rapidly.

Chest Pain: A Key Warning Sign

Chest pain is one of the most frequently reported symptoms among individuals experiencing pulmonary embolism—and this holds true for pregnant women as well. The pain is often sharp, localized, and may intensify with deep breathing or coughing. In expectant mothers, chest discomfort can sometimes be mistaken for heartburn or musculoskeletal strain due to postural changes. However, persistent or severe chest pain requires immediate medical evaluation to rule out a clot in the lungs.

Shortness of Breath: More Than Just Pregnancy Fatigue

Dyspnea, or shortness of breath, is another hallmark symptom of PE. While mild breathlessness is common during pregnancy due to increased abdominal pressure from the growing uterus and elevated diaphragm, sudden or unexplained worsening of breathing difficulty should raise red flags. When a pulmonary artery becomes obstructed by a clot, oxygen exchange is impaired, leading to noticeable respiratory distress—even at rest. Pregnant women who experience abrupt onset of breathlessness, particularly without exertion, should seek urgent care.

Hemoptysis: Coughing Up Blood – A Serious Indicator

Coughing up blood (hemoptysis) is a less common but highly concerning sign of pulmonary embolism. In late pregnancy, some women may develop coagulation abnormalities such as disseminated intravascular coagulation (DIC), which can also lead to bleeding. This makes it challenging to determine whether hemoptysis stems from a clot-related lung injury or an underlying clotting disorder. Either way, the presence of blood in sputum demands prompt investigation through imaging and lab tests to ensure accurate diagnosis and treatment.

Respiratory Symptoms: Cough and Sputum Production

In addition to more dramatic symptoms, many pregnant patients report seemingly routine respiratory complaints such as dry cough or production of mucus. These may initially be attributed to seasonal allergies or minor infections. However, when accompanied by other signs like tachycardia, fever, or low oxygen saturation, they could point toward a developing pulmonary embolism. Clinicians must maintain a high index of suspicion, especially in high-risk pregnancies.

Chest Tightness and Underlying Heart Conditions

Chest tightness or pressure is another symptom that may occur, particularly in women with pre-existing cardiac conditions or gestational hypertension. The cardiovascular system undergoes significant stress during pregnancy, and the added burden of a pulmonary clot can exacerbate symptoms of ischemia or heart strain. Women with a history of hypertension, preeclampsia, or congenital heart disease are at higher risk and should be closely monitored throughout their pregnancy journey.

In conclusion, while some symptoms of pulmonary embolism overlap with normal pregnancy discomforts, any sudden or severe change in breathing, chest sensation, or overall well-being warrants immediate attention. Early recognition, combined with appropriate diagnostic tools like D-dimer testing, ultrasound, and CT pulmonary angiography (when safe), can save lives. Expectant mothers and healthcare providers alike must remain vigilant to protect both maternal and fetal health.