Key result
Thrombolysis and targeted temperature management enable full maternal neurological recovery after PE-induced cardiac arrest.
Why the study?
Thrombolysis for pulmonary embolism and targeted temperature management for cardiac arrest are controversial treatments during pregnancy.
Can thrombolysis and targeted temperature management successfully treat pulmonary embolism-induced cardiac arrest during pregnancy?
Case Report (n=1)
Can thrombolysis and targeted temperature management successfully treat pulmonary embolism-induced cardiac arrest during pregnancy?
Thrombolysis and targeted temperature management can be life-saving for pregnant women with pulmonary embolism-induced cardiac arrest, though fetal risks remain high.
Supports cautious thrombolysis consideration in pregnant PE arrest; leaves open need for controlled safety and outcome data.
BACKGROUND: Thrombolysis for pulmonary embolism and targeted temperature management for cardiac arrest are controversial treatments in pregnancy. CASE: A 37-year-old woman at 23 weeks gestation presented with persistent dyspnea. She experienced cardiac arrest soon after arrival at the emergency room. Massive right ventricular dilatation on echocardiography during the transient return of spontaneous circulation suggested pulmonary embolism. We administered recombinant tissue plasminogen activator for suspected pulmonary embolism to successfully resuscitate the patient experiencing refractory cardiac arrest despite heparin infusion. After an additional dose of monteplase for persistent shock with remaining right ventricular dilatation on echocardiography, maternal hemodynamics dramatically improved, but fetal heart rate transiently decreased. Targeted temperature management was initiated for delayed recovery of consciousness. She fully recovered consciousness without neurological deficit. However, the fetus was aborted because of fetal hydrops. CONCLUSION: Thrombolysis and targeted temperature management should be considered as treatment options for pulmonary embolism-induced cardiac arrest during pregnancy.
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Oami et al. (2018) conducted a case report in Pulmonary embolism-induced cardiac arrest during pregnancy (n=1). Thrombolysis and targeted temperature management was evaluated on Maternal and fetal survival and recovery. Thrombolysis and targeted temperature management successfully resuscitated a pregnant woman with pulmonary embolism-induced cardiac arrest, leading to full neurological recovery, though the fetus was aborted.
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