• Obstetrics and gynecology · Nov 2005

    Case Reports

    Massive pulmonary embolism in pregnancy treated with tissue plasminogen activator.

    • Elena Trukhacheva, Michael Scharff, Michael Gardner, and Nasser Lakkis.
    • Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas 77054, USA. elenat@bcm.tmc.edu
    • Obstet Gynecol. 2005 Nov 1;106(5 Pt 2):1156-8.

    BackgroundSystemic thrombolysis with tissue plasminogen activator (t-PA) in pregnancy is still considered an experimental treatment. Several reports have described the successful use of t-PA in the setting of hemodynamic instability in gravidas with massive pulmonary emboli.CaseA 34-year-old woman received a diagnosis of severe pulmonary embolism at 23 weeks of gestation. She developed pulmonary hypertension and became hemodynamically unstable. Thrombolytic therapy using t-PA was administered. The patient tolerated thrombolysis well and delivered at term. No placental abnormalities were identified on ultrasonogram or after delivery. The patient was also found to be a heterozygous carrier of prothrombin G20210A mutation.ConclusionWe describe the successful thrombolysis with t-PA of a massive, life-threatening pulmonary embolism without complications followed by a term delivery.

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