Trukhacheva Elena, Scharff Michael, Gardner Michael, Lakkis Nasser
Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas 77054, USA.
Obstet Gynecol. 2005 Nov;106(5 Pt 2):1156-8. doi: 10.1097/01.AOG.0000164059.72933.9c.
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.
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.
We describe the successful thrombolysis with t-PA of a massive, life-threatening pulmonary embolism without complications followed by a term delivery.
在孕期使用组织型纤溶酶原激活剂（t-PA）进行全身溶栓仍被视为一种实验性治疗方法。有几份报告描述了t-PA在患有大面积肺栓塞的孕妇出现血流动力学不稳定情况下的成功应用。
一名34岁女性在妊娠23周时被诊断为严重肺栓塞。她出现了肺动脉高压并出现血流动力学不稳定。给予了使用t-PA的溶栓治疗。患者对溶栓耐受良好并足月分娩。超声检查或产后均未发现胎盘异常。该患者还被发现是凝血酶原G20210A突变的杂合子携带者。
我们描述了使用t-PA成功溶栓治疗一例大面积、危及生命的肺栓塞且无并发症，随后足月分娩的病例。
