Massive subchorionic hematomas following thrombolytic therapy in pregnancy.
BACKGROUND
Medical therapy for thrombosed valve in pregnancy has become an acceptable alternative to surgery, especially in hemodynamically compromised patients. Placental changes after thrombolytic therapy have rarely been reported.


METHODS
Sonograms were done within 24 hours after administration of thrombolytic agents at 15 and 26 weeks of gestation, respectively, in 2 women whose pregnancies were complicated with thrombosis of prosthetic mitral valves. Both patients developed massive subchorionic hematomas, which persisted in 1 patient who underwent cesarean delivery at 34 weeks of gestation for cardiac indications (Apgar scores 9 and 10 at 1 minute and 5 minutes, respectively). The hematomas resolved in the other patient, who delivered at term.


CONCLUSIONS
Massive subchorionic hematomas may be observed in patients after thrombolytic therapy. Other reports are needed to establish whether such placental findings are common lesions after such therapy and to determine their impact on pregnancy outcome.
Usta
Ihab M
IM
Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon. iu00@aub.edu.lb
Abdallah
Mazen
M
El-Hajj
May
M
Nassar
Anwar H
AH
D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006406:Hematoma / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D008943:Mitral Valve; D010922:Placenta Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000000981:diagnostic imaging / Q000188:drug therapy*; D011256:Pregnancy Outcome; D015912:Thrombolytic Therapy / Q000009:adverse effects*; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D014463:Ultrasonography
D000925:Anticoagulants; D005343:Fibrinolytic Agents