Open AccessAcute Massive Pulmonary Embolism Treated with Streptokinase During Labor and the Early Puerperium
Author(s) -
Fagher Birger,
Ahlgren Mats,
Astedt Birger
Publication year - 1990
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.3109/00016349009028716
Subject(s) - streptokinase , medicine , pulmonary embolism , heparin , anesthesia , perfusion , pregnancy , lung , surgery , cardiology , myocardial infarction , biology , genetics
Acute massive pulmonary embolism occluding 60‐70% of the pulmonary circulation occurred in a young primipara during the 28th week of pregnancy. She was critically ill despite 40 h of heparin infusion and thrombolytic therapy with streptokinase was initiated. After a 10‐h infusion she went into labor and streptokinase treatment was stopped. One hour later she gave birth spontaneously to a preterm infant in footling breech delivery. The infant did well neonatally. Streptokinase infusion was recommenced 8 h after delivery. Because of increasing blood loss on the second day after delivery, streptokinase was withdrawn after a total treatment time of 29 h. Total hemorrhage amounted to 8.9 litres. Serial perfusion lung scans showed complete resolution of the emboli and normal lung function was restored.