Pulmonary Embolism and Pregnancy—Challenges in Diagnostic and Therapeutic Decisions in High-Risk Patients

Frontiers in Cardiovascular Medicine

Ioannis T. Farmakis¹  Lukas Hobohm¹  Stavros Konstantinides²  Thomas Münzel⁴  Karsten Keller⁵ 

[1] Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg University, Mainz, Germany;Department of Cardiology, Democritus University of Thrace, Komotini, Greece;Department of Cardiology, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany;German Center for Cardiovascular Research (DZHK), Partner Site Rhine Main, Mainz, Germany;Medical Clinic VII, University Hospital Heidelberg, Heidelberg, Germany;

关键词: pulmonary embolism;    pregnancy;    thrombolysis;    outcome;    venous thromboembolism;   

DOI  :  10.3389/fcvm.2022.856594

来源: DOAJ

【 摘 要 】

Diagnosis of acute PE in pregnant women with haemodynamic instability is following the general integrated risk-adapted diagnostic algorithm and starts with bedside echocardiography to assess RV function. If RV dysfunction is identified, a prompt and immediate reperfusion without further imaging should be initiated. Although pregnancy is listed as a relative contraindication of systemic thrombolysis, in pregnant women with acute PE and haemodynamic instability thrombolysis must be considered. In those cases, other treatment strategies as surgical embolectomy or catheter-directed low-dose thromboylysis or percutaneous thrombectomy should be taken into consideration as well. A multidisciplinary team with experience of PE management in pregnancy should be consulted to reach consensus on the best treatment approach.

【 授权许可】

Unknown