Successful low-dose thrombolysis of submassive pulmonary embolus in a pregnant patient

Abstract

LessonLow-dose thrombolysis was effective and safe in a pregnant woman with acute pulmonary embolism causing severe right ventricular dysfunction.This is the first reported case of successful thrombolysis for pulmonary embolus in pregnancy in the absence of shock.

Successful treatment of pulmonary embolism‐induced cardiac arrest by thrombolysis and targeted temperature management during pregnancy

“…Although heparin can be safely used for PE during pregnancy, use of thrombolytic agents for PE complicated by shock or hypotension during pregnancy is highly controversial due to the risk of bleeding complications and miscarriage . According to recent published works, 19 cases of successful maternal treatment using rtPA have been reported, with complicating fetal death in one case and a minor bleeding episode in another . Our case required an additional dose of monteplase for refractory shock with persisting right ventricular dilatation 30 min after the initial dose.…”