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Massive Pulmonary Embolism During Pregnancy Successfully Treated With Recombinant Tissue Plasminogen Activator
A Case Report and Review of Treatment Options
Gregory S. Ahearn, MD;
Denis Hadjiliadis, MD;
Joseph A. Govert, MD;
Victor F. Tapson, MD
Arch Intern Med. 2002;162:1221-1227.
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| Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings. |
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INTRODUCTION
Thromboembolic disease is an important cause of morbidity and mortality
during pregnancy.1 Berg and colleagues2 found that 11% of maternal deaths during pregnancy
were related to pulmonary embolism (PE). Another study revealed that up to
40% of pregnant women with asymptomatic deep vein thrombosis (DVT) may also
have concurrent PE.3 Women are at increased
risk for DVT and PE during pregnancy for several reasons. Pregnancy is a thrombophilic
state; fibrinogen levels are increased, and during the final trimester there
is a decrease in fibrinolytic activity. In addition, the gravid uterus causes
compression and stasis in the lower extremities and pelvic veins favoring
thrombosis.3 Finally, women with a history
of thrombotic complications during pregnancy have an increased prevalence
of genetic mutations related to coagulation.4
Traditionally, thromboembolic disease during pregnancy has been treated
with unfractionated5 and, more . . . [Full Text of this Article]
REPORT OF A CASE
EMBOLECTOMY
THROMBOLYTIC THERAPY
CATHETER-DIRECTED THROMBOLYTIC THERAPY
VENA CAVA FILTERS
CONCLUSIONS
From the Department of Medicine, Division of Pulmonary and Critical
Care, Duke University Medical Center, Durham, NC.
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