title: Massive pulmonary embolism in pregnancy treated with tissue plasminogen activator.
abstract: BACKGROUND
  Systemic 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.
  
  
  METHODS
  A 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.
  
  
  CONCLUSIONS
  We describe the successful thrombolysis with t-PA of a massive, life-threatening pulmonary embolism without complications followed by a term delivery.
authors.affiliation: Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas 77054, USA. elenat@bcm.tmc.edu
authors.forename: Elena
authors.initials: E
authors.lastname: Trukhacheva
authors.forename: Michael
authors.initials: M
authors.lastname: Scharff
authors.forename: Michael
authors.initials: M
authors.lastname: Gardner
authors.forename: Nasser
authors.initials: N
authors.lastname: Lakkis
mesh_terms: D000328:Adult; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006579:Heterozygote; D006801:Humans; D009154:Mutation; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics; D011256:Pregnancy Outcome; D011262:Pregnancy Trimester, Second; D011516:Prothrombin / Q000235:genetics; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*
chemical_list: D005343:Fibrinolytic Agents; D011516:Prothrombin; D010959:Tissue Plasminogen Activator