Anesthetic management of cesarean section in a patient with pulmonary embolism due to protein S deficiency diagnosed postoperatively

A 27-year-old pregnant woman with pulmonary embolism was scheduled for cesarean section. She received anticoagulant therapy with continuous infusion of heparin and prophylactic placement of an inferior vena cava (IVC) filter. Heparin was discontinued 7 hours before operation. Spinal anesthesia using hyperbaric bupivacaine 12 mg was performed and the operation was completed uneventfully. She was given a diagnosis of protein S deficiency after discharge. Preoperative anticoagulant therapy and placement of IVC filter may be effective in preventing new pulmonary embolism.