Massive pulmonary embolism in pregnancy treated with catheter-directed tissue plasminogen activator

A A Case Rep. 2015 Apr 1;4(7):91-4. doi: 10.1213/XAA.0000000000000128.


Pulmonary embolism is a leading cause of maternal death in the United States, contributing to the death of approximately 2 women per 100,000 live births each year. Thrombosis during pregnancy traditionally is treated conservatively with unfractionated heparin or low-molecular-weight heparin; however, cardiovascular collapse associated with a large pulmonary embolus may require immediate aggressive intervention to save the mother and fetus. We report the use of catheter infusion thrombolysis in the successful management of a third-trimester pregnant patient with a hemodynamically significant saddle pulmonary embolus.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Female
  • Fibrinolytic Agents / therapeutic use*
  • Heparin, Low-Molecular-Weight / therapeutic use
  • Humans
  • Pregnancy
  • Pregnancy Complications, Cardiovascular / drug therapy
  • Pregnancy Outcome
  • Pregnancy Trimester, Third
  • Pulmonary Embolism / drug therapy*
  • Thrombolytic Therapy / methods*
  • Tissue Plasminogen Activator / therapeutic use*
  • Vascular Access Devices


  • Fibrinolytic Agents
  • Heparin, Low-Molecular-Weight
  • Tissue Plasminogen Activator