• W B Kramer, M Belfort, G R Saade, S Surani, and K J Moise.
• Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas, USA.
• Obstet Gynecol. 1995 Oct 1;86(4 Pt 2):660-2.

BackgroundThrombolytic agents have been used successfully to treat patients with massive pulmonary embolism and cardiorespiratory insufficiency, but experience with these drugs in pregnancy is limited.CaseA 20-year-old woman at 21 weeks' gestation was admitted with a massive pulmonary embolism. She was initially given intravenous heparin therapy but because of worsening clinical condition, urokinase was used. After two 12-hour periods of therapy, the urokinase was discontinued and the heparin restarted. She remained on subcutaneous heparin therapy for the remainder of her pregnancy, which was otherwise uncomplicated. She delivered a healthy male infant at term without complications and was discharged on warfarin therapy.ConclusionThrombolytic therapy can be life-saving and should be considered in the treatment of hemodynamically significant pulmonary embolism in pregnancy.

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