Peksa Gary D, Ostrem Jamie, Davis Teresa
Department of Pharmacy, Rush University Medical Center, Chicago, IL, USA.
Department of Emergency Medicine, Rush University Medical Center, Chicago, IL, USA.
SAGE Open Med Case Rep. 2019 Feb 8;7:2050313X19828247. doi: 10.1177/2050313X19828247. eCollection 2019.
Few published reports highlight intravenous tissue plasminogen activator use during the first trimester of pregnancy and provide outcomes for mother and fetus. Little guidance is available regarding body weight dosing of intravenous tissue plasminogen activator during pregnancy.
Here, we present a patient who received intravenous tissue plasminogen activator in the emergency department during her first trimester of pregnancy for the treatment of an acute ischemic stroke. Outcomes are presented for mother and fetus, as well as discussion about the dosing weight utilized for the intravenous tissue plasminogen activator dose calculation.
A 35-year-old, Gravida 7 Para 6, presented to the emergency department at 9 weeks gestation with acute stroke symptoms. Her initial National Institutes of Health Stroke Scale was 7. Imaging revealed a hyperdense right middle cerebral artery sign. Intravenous tissue plasminogen activator was administered 57 min after her arrival and based on her actual body weight during pregnancy. Post tissue plasminogen activator imaging revealed recanalization of the vessel and the patient's National Institutes of Health Stroke Scale was 0. The patient progressed to delivery of a healthy female infant. The patient did not experience any bleeding complications throughout pregnancy.
We present positive outcomes of a mother and fetus after receipt of intravenous tissue plasminogen activator using actual body weight during the first trimester of pregnancy for an acute ischemic stroke. Additional information is necessary to provide recommendations for the application to future patients in early pregnancy.
很少有已发表的报告强调在妊娠早期使用静脉注射组织型纤溶酶原激活剂，并提供母亲和胎儿的结局。关于妊娠期间静脉注射组织型纤溶酶原激活剂的体重给药，几乎没有可用的指导意见。
在此，我们介绍一名患者，她在妊娠早期于急诊科接受静脉注射组织型纤溶酶原激活剂治疗急性缺血性卒中。报告了母亲和胎儿的结局，并讨论了用于静脉注射组织型纤溶酶原激活剂剂量计算的给药体重。
一名35岁、孕7产6的患者，在妊娠9周时因急性卒中症状就诊于急诊科。她最初的美国国立卫生研究院卒中量表评分为7分。影像学检查显示右侧大脑中动脉高密度征。在她到达后57分钟，根据她妊娠期间的实际体重给予静脉注射组织型纤溶酶原激活剂。组织型纤溶酶原激活剂治疗后的影像学检查显示血管再通，患者的美国国立卫生研究院卒中量表评分为0分。患者顺利分娩一名健康女婴。患者在整个孕期未出现任何出血并发症。
我们报告了一名母亲在妊娠早期因急性缺血性卒中使用静脉注射组织型纤溶酶原激活剂并根据实际体重给药后，母亲和胎儿均获得良好结局。需要更多信息才能为未来早孕患者的应用提供建议。
