Successful experience with systemic thrombolysis during pregnancy


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Abstract

Background: Pulmonary embolism (PE) is the most serious venous thromboembolic event (VTE) and the leading cause of death in pregnant women and puerperas. The change in the hemostasiogram parameters (except for D-dimers) in VTE practically does not differ from that in physiological pregnancy. The first-line therapy for PE is drug treatment with thrombolytics and anticoagulants, the use of which in pregnant women is associated with a high risk for obstetric bleeding and adverse perinatal outcomes. Case report: The paper presents the results of examination and treatment in a 34-year-old female patient with PE that occurred at 24 weeks’ gestation and was diagnosed using chest computed tomography and pulmonary angiography. A systemic thrombolytic session was performed, followed by the placement of an inferior vena cava filter and by the administration of low-molecular-weight heparins at therapeutic doses, which allowed the patient to prolong pregnancy to full term and to give birth to a healthy baby. Conclusion: The appearance of clinical symptoms (in this case, exertional dyspnea) is of paramount importance in predicting life-threatening pathological conditions and requires a detailed follow-up within the framework of timely diagnosis and specialized medical care.

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About the authors

Alexander N. Strizhakov

I.M. Sechenov First Moscow State Medical University (Sechenov University) Ministry of Health of Russia

Email: kafedra-agp@mail.ru
Dr. Med. Sci., Academician of the Russian Academy of Sciences, Professor, Head of the Department of Obstetrics, Gynecology and Perinatology of the N.V. Sklifosovsky Institute of Clinical Medicine 8-2 Trubetskaya str., Moscow, 119991, Russia

Irina V. Ignatko

I.M. Sechenov First Moscow State Medical University (Sechenov University) Ministry of Health of Russia

Email: kafedra-agp@mail.ru
Dr. Med. Sci., Corresponding Member of the Russian Academy of Sciences, Professor of the Russian Academy of Sciences, Professor, Professor of the Department of Obstetrics, Gynecology and Perinatology of the N.V. Sklifosovsky Institute of Clinical Medicine 8-2 Trubetskaya str., Moscow, 119991, Russia

Irina M. Bogomazova

I.M. Sechenov First Moscow State Medical University (Sechenov University) Ministry of Health of Russia

Email: irinka.bogomazova@mailru
PhD, Associate Professor of the Department of Obstetrics, Gynecology and Perinatology of the N.V. Sklifosovsky Institute of Clinical Medicine 8-2 Trubetskaya str., Moscow, 119991, Russia

Vera S. Belousova

I.M. Sechenov First Moscow State Medical University (Sechenov University) Ministry of Health of Russia

Email: kafedra-agp@mailru
PhD, Associate Professor, Associate Professor of the Department of Obstetrics, Gynecology and Perinatology of the N.V. Sklifosovsky Institute of Clinical Medicine 8-2 Trubetskaya str., Moscow, 119991, Russia

Elena V. Timokhina

I.M. Sechenov First Moscow State Medical University (Sechenov University) Ministry of Health of Russia

Email: kafedra-agp@mailru
Dr. Med. Sci., Associate Professor, Professor of the Department of Obstetrics, Gynecology and Perinatology of the N.V. Sklifosovsky Institute of Clinical Medicine 8-2 Trubetskaya str., Moscow, 119991, Russia

Natalia V. Afanasyeva

S.S. Yudin City Clinical Hospital Moscow Healthcare Department

Email: gkb-yudina@zdrav.mos.ru
PhD, Head of the Family Planning Center 115446, Russia, Moscow, Kolomensky proezd, 4

Leontina S. Khramova

S.S. Yudin City Clinical Hospital Moscow Healthcare Department

Email: gkb-yudina@zdrav.mos.ru
PhD, obstetrician-gynecologist of the Maternity Hospital 115446, Russia, Moscow, Kolomensky proezd, 4

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