Immediate postpartum cardiorespiratory collapse: a management quandary.
A 35-year-old multiparous woman was found unresponsive, tachypnoeic, hypoxic and in shock 4 h postpartum. The ECG revealed S1 Q3 T3, a right bundle branch block pattern and right-axis deviation. The computed tomography of her pulmonary arteries revealed bilateral pulmonary artery thrombosis with dilated right ventricle. She was fibrinolyzed with intravenous Tenecteplase 30 mg bolus. Her saturation and tachypnoea improved and her ECG reverted to sinus rhythm subsequently. We discuss our use of off-label Tenecteplase in postpartum pulmonary embolism and review the literature.
Azarisman
Shah M S
SM
International Islamic University Malaysia, Jalan Sultan Ahmad Shah, 25200 Kuantan, Pahang Darul Makmur, Malaysia. risman1973@hotmail.com
Liza
Roslani A
RA
Radhiana
Hassan
H
Sujana
Saravanamuttu S
SS
Maskon
Oteh
O
Rosli
Mohd A
MA
Fauzi
Abdul R M
AR
D000328:Adult; D002037:Bundle-Branch Block / Q000209:etiology*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D049590:Postpartum Period; D011651:Pulmonary Artery / Q000000981:diagnostic imaging; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D000077785:Tenecteplase; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D010959:Tissue Plasminogen Activator; D000077785:Tenecteplase