Pulmonary Embolism and Pregnancy-Challenges in Diagnostic and Therapeutic Decisions in High-Risk Patients.
outcome
pregnancy
pulmonary embolism
thrombolysis
venous thromboembolism
Journal
Frontiers in cardiovascular medicine
ISSN: 2297-055X
Titre abrégé: Front Cardiovasc Med
Pays: Switzerland
ID NLM: 101653388
Informations de publication
Date de publication:
2022
2022
Historique:
received:
17
01
2022
accepted:
10
02
2022
entrez:
30
3
2022
pubmed:
31
3
2022
medline:
31
3
2022
Statut:
epublish
Résumé
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.
Identifiants
pubmed: 35350540
doi: 10.3389/fcvm.2022.856594
pmc: PMC8957783
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
856594Informations de copyright
Copyright © 2022 Hobohm, Farmakis, Münzel, Konstantinides and Keller.
Déclaration de conflit d'intérêts
LH reports lecture/consultant fees from MSD and Janssen, outside the submitted work. SK reports institutional grants and personal lecture/consultant fees from Bayer AG, Daiichi-Sankyo, and Boston Scientific; institutional grants from Inari Medical; and personal lecture/consultant fees from Pfizer- Bristol-Myers Squibb and MSD, all outside the submitted work.
Références
Ann Vasc Surg. 2017 Jan;38:242-247
pubmed: 27521826
Lancet Haematol. 2020 Mar;7(3):e247-e258
pubmed: 32109405
J Thromb Haemost. 2013 Feb;11(2):270-81
pubmed: 23205953
Eur Heart J. 2020 Jan 21;41(4):522-529
pubmed: 31102407
Chest. 2018 Jan;153(1):152-160
pubmed: 28823756
J Perinatol. 2010 Apr;30(4):253-7
pubmed: 19829297
Chest. 2015 Sep;148(3):667-673
pubmed: 25856269
Chest. 2002 Mar;121(3):877-905
pubmed: 11888976
Expert Rev Med Devices. 2020 Aug;17(8):739-749
pubmed: 32700589
Am J Obstet Gynecol. 2001 Jul;185(1):148-52
pubmed: 11483919
Radiology. 2012 Feb;262(2):635-46
pubmed: 22282185
J Vasc Interv Radiol. 2016 May;27(5):730-4
pubmed: 27106647
EuroIntervention. 2013 Apr 22;8(12):1419-27
pubmed: 23680957
Ann Intern Med. 2018 Dec 4;169(11):766-773
pubmed: 30357273
J Nucl Med. 2014 Aug;55(8):1273-80
pubmed: 24876205
Chest. 2016 Feb;149(2):315-352
pubmed: 26867832
J Thromb Haemost. 2016 Aug;14(8):1673-6
pubmed: 27346676
Blood Coagul Fibrinolysis. 2017 Apr;28(3):199-204
pubmed: 27254442
J Thromb Thrombolysis. 2017 Jan;43(1):105-111
pubmed: 27517381
Eur Heart J. 2020 Jan 21;41(4):543-603
pubmed: 31504429
Obstet Gynecol. 2019 Nov;134(5):1002-1004
pubmed: 31599843
JACC Cardiovasc Interv. 2019 May 13;12(9):859-869
pubmed: 31072507
Cochrane Database Syst Rev. 2017 Jan 26;1:CD011053
pubmed: 28124411
Heart Lung Circ. 2015 Jan;24(1):46-54
pubmed: 25060976
JACC Cardiovasc Interv. 2018 Jul 23;11(14):1401-1410
pubmed: 30025734
J Thromb Thrombolysis. 2006 Jun;21(3):271-6
pubmed: 16683220
Pharmacotherapy. 2017 Nov;37(11):1449-1457
pubmed: 28891082
Acute Med. 2016;15(2):58-62
pubmed: 27441306
N Engl J Med. 1998 Feb 12;338(7):409-15
pubmed: 9459643
Res Pract Thromb Haemost. 2019 Aug 01;3(4):607-614
pubmed: 31624780
J Am Coll Cardiol. 1999 May;33(6):1637-41
pubmed: 10334435
Aust N Z J Obstet Gynaecol. 2012 Feb;52(1):14-22
pubmed: 21972999
Circulation. 2015 Sep 8;132(10):944-52
pubmed: 26169756
ESC Heart Fail. 2020 Oct;7(5):2365-2372
pubmed: 32567197
EuroIntervention. 2021 Jun 11;17(2):e158-e166
pubmed: 32863245
J Thromb Haemost. 2017 Oct;15(10):1942-1950
pubmed: 28805341
Circ Res. 2016 Apr 29;118(9):1340-7
pubmed: 27126645
Lancet Respir Med. 2020 Mar;8(3):277-287
pubmed: 31615719
EuroIntervention. 2018 Nov 20;14(10):1136-1143
pubmed: 30082262
Br J Haematol. 2007 Nov;139(4):545-58
pubmed: 17916101
Int Angiol. 2017 Oct;36(5):428-437
pubmed: 28206731
Thromb Res. 2021 Aug;204:57-65
pubmed: 34146979
J Vasc Interv Radiol. 2019 Sep;30(9):1370-1375
pubmed: 31375449
Blood. 2005 Oct 15;106(8):2710-5
pubmed: 15985543
Vasa. 2019 Jul;48(4):341-346
pubmed: 30785373
Circulation. 2014 Jan 28;129(4):479-86
pubmed: 24226805
JACC Case Rep. 2020 Oct 21;2(12):1899-1904
pubmed: 34317077
Obstet Gynecol. 2010 Dec;116(6):1302-1309
pubmed: 21099595
J Obstet Gynaecol Can. 2014 Jun;36(6):527-53
pubmed: 24927193
Gen Thorac Cardiovasc Surg. 2016 Jun;64(6):309-14
pubmed: 26965421
N Engl J Med. 2004 Apr 29;350(18):1914-5
pubmed: 15115845
N Engl J Med. 2019 Jun 20;380(25):e49
pubmed: 31216413
Resuscitation. 2022 Jan;170:285-292
pubmed: 34653550
Blood Adv. 2018 Nov 27;2(22):3317-3359
pubmed: 30482767
Eur J Nucl Med Mol Imaging. 2009 Sep;36(9):1528-38
pubmed: 19629478
Med Klin Intensivmed Notfmed. 2021 Aug 24;:
pubmed: 34430980
Ann Intern Med. 2005 Nov 15;143(10):697-706
pubmed: 16287790
Clin Res Cardiol. 2016 Feb;105(2):117-26
pubmed: 26195125
Semin Thromb Hemost. 2013 Jul;39(5):549-58
pubmed: 23633191
Eur Heart J Acute Cardiovasc Care. 2021 May 11;10(3):258-264
pubmed: 33620441
Thromb Res. 2017 Sep;157:23-28
pubmed: 28686913
J Am Coll Cardiol. 2017 Sep 26;70(13):1587-1597
pubmed: 28935036
Vasa. 2016;45(2):87-101
pubmed: 27058795
J Vasc Interv Radiol. 2016 Mar;27(3):354-60.e8
pubmed: 26746328