Acute Symmetric Arterial Thrombosis of the Four Extremities Associated with Pregnancy: Case Report

During the normal process of pregnancy, there is a procoagulant state derived from the alteration of all the components of the Virchow Triad. Multiple biochemical and structural changes lead to an increased risk of thromboembolic events. Although venous embolic events are more common, arterial thrombosis generally leads to devastating outcomes. Anticoagulation in pregnant patients has very specific indications, primarily in patients with a history of thromboembolism or poor obstetric history. There are multiple drugs used for venous or arterial thrombosis, some of which are associated with teratogenic effects, the most commonly used being low molecular weight heparin. In cases of valve prosthesis and antiphospholipid syndrome, antiplatelet drugs should be added. Shock is the main cause of admission and mortality in intensive care units. In the absence of myocardial dysfunction, hypotension is primarily caused by hypovolemia and the physiological inability to self-regulate and adequately perfuse. In these cases, there are guidelines for the use of vasopressors, aimed at maintaining adequate perfusion to essential organs. However, the use of these drugs may be associated with adverse effects, including the possibility of ischemia in some anatomical regions. In this article, we present the case of a multi-pregnant patient with the presence of several etiopathogenic factors that triggered distal necrosis of all four extremities, requiring amputation.