Acute massive pulmonary embolism treated with streptokinase during labor and the early puerperium.
Acute massive pulmonary embolism occluding 60-70% of the pulmonary circulation occurred in a young primipara during the 28th week of pregnancy. She was critically ill despite 40 h of heparin infusion and thrombolytic therapy with streptokinase was initiated. After a 10-h infusion she went into labor and streptokinase treatment was stopped. One hour later she gave birth spontaneously to a preterm infant in footling breech delivery. The infant did well neonatally. Streptokinase infusion was recommenced 8 h after delivery. Because of increasing blood loss on the second day after delivery, streptokinase was withdrawn after a total treatment time of 29 h. Total hemorrhage amounted to 8.9 litres. Serial perfusion lung scans showed complete resolution of the emboli and normal lung function was restored.
Fagher
B
B
Department of Internal Medicine, University Hospital, Lund, Sweden.
Ahlgren
M
M
Astedt
B
B
D000208:Acute Disease; D000328:Adult; D005260:Female; D006801:Humans; D007744:Obstetric Labor Complications / Q000188:drug therapy*; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000188:drug therapy*; D011644:Puerperal Disorders / Q000188:drug therapy; D011655:Pulmonary Embolism / Q000188:drug therapy*; D013300:Streptokinase / Q000627:therapeutic use*; D015912:Thrombolytic Therapy
D013300:Streptokinase