A Case report of acute pulmonary embolism in pregnancy managed by systemic thrombolysis

Abstract

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.