Why the study?
Systemic thrombolysis is considered high-risk in pregnancy and very few women have received it, despite acceptable complication rates given the underlying severity of pulmonary embolism.
Systemic thrombolysis with tenecteplase can be a viable and safe life-saving treatment for massive pulmonary embolism with persistent hypotension during pregnancy.
Supports potential role of tenecteplase for unstable PE in pregnancy; leaves open safety and efficacy questions for broader application.
A case of a 37-year-old pregnant woman at 29 weeks of gestation presented to our hospital with syncope and shortness of breath. We diagnosed her as a case of bilateral pulmonary thromboembolism. Due to Persistent hypotension, thrombolytic therapy with tenecteplase was administered. The clinical and hemodynamic response was excellent, with no maternal or fetal hemorrhagic complications. The clinical presentation of pulmonary embolism is sometimes challenging to identify due to resemblance to physiological pregnancy changes. The diagnosis gets delayed by the reluctance to expose the fetus to ionizing radiation. Systemic thrombolysis is considered a high-risk treatment in pregnancy, and very few women have received it. However, the complication rates of thrombolytic therapy are acceptable in the view of the underlying disease.
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Sindhuri et al. (2020) studied this question.
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