title: Successful urokinase treatment of massive pulmonary embolism in pregnancy.
abstract: BACKGROUND
  Thrombolytic agents have been used successfully to treat patients with massive pulmonary embolism and cardiorespiratory insufficiency, but experience with these drugs in pregnancy is limited.
  
  
  METHODS
  A 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.
  
  
  CONCLUSIONS
  Thrombolytic therapy can be life-saving and should be considered in the treatment of hemodynamically significant pulmonary embolism in pregnancy.
authors.affiliation: Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: W B
authors.initials: WB
authors.lastname: Kramer
authors.forename: M
authors.initials: M
authors.lastname: Belfort
authors.forename: G R
authors.initials: GR
authors.lastname: Saade
authors.forename: S
authors.initials: S
authors.lastname: Surani
authors.forename: K J
authors.initials: KJ
authors.lastname: Moise
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000188:drug therapy*; D011655:Pulmonary Embolism / Q000188:drug therapy*; D012074:Remission Induction; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use*
chemical_list: D014568:Urokinase-Type Plasminogen Activator