Successful treatment of massive pulmonary embolism with recombinant tissue type plasminogen activator (rt-PA) in a pregnant woman with intact gravidity and preterm labour.
We report a patient with massive pulmonary embolism and circulatory shock during pregnancy (31st gestational week) and preterm labour who has been successfully treated with recombinant tissue type plasminogen activator. Thrombolysis was performed using 10 mg.h-1 over 4 h followed by 2 mg.h-1 for 1 h 30 min resulting in complete resolution of cardio-respiratory symptoms. Except for slight bleeding from one puncture site no complications occurred. At 48 h after the end of thrombolytic therapy the patient was delivered spontaneously of a male preterm healthy infant. The relevance of this new thrombolytic agent in the treatment of massive life-threatening pulmonary embolism during pregnancy is discussed.
Flossdorf
T
T
Abteilung für Klinische Anaesthesiologie, Zentrum für Anaesthesiologie Heinrich-Heine-Universität, Düsseldorf, FRG.
Breulmann
M
M
Hopf
H B
HB
D000328:Adult; D001794:Blood Pressure; D002245:Carbon Dioxide / Q000097:blood; D005260:Female; D006339:Heart Rate; D006801:Humans; D007231:Infant, Newborn; D007752:Obstetric Labor, Premature; D010100:Oxygen / Q000097:blood; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000188:drug therapy*; D011651:Pulmonary Artery / Q000503:physiopathology; D011655:Pulmonary Embolism / Q000188:drug therapy* / Q000503:physiopathology; D011994:Recombinant Proteins / Q000627:therapeutic use; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*
D011994:Recombinant Proteins; D002245:Carbon Dioxide; D010959:Tissue Plasminogen Activator; D010100:Oxygen