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Pulmonary embolism and pregnancy: challenges in diagnostic and therapeutic decisions in high-risk patients

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 shou...

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Main Authors: Hobohm, Lukas (Author) , Farmakis, Ioannis T. (Author) , Münzel, Thomas (Author) , Konstantinides, Stavros (Author) , Keller, Karsten (Author)
Format: Article (Journal)
Language:English
Published: 08 March 2022
In: Frontiers in Cardiovascular Medicine
Year: 2022, Volume: 9, Pages: 1-8
ISSN:2297-055X
Online Access:Verlag, lizenzpflichtig, Volltext: https://www.frontiersin.org/article/10.3389/fcvm.2022.856594
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Author Notes:Lukas Hobohm, Ioannis T. Farmakis, Thomas Münzel, Stavros Konstantinides and Karsten Keller

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520 |a 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. 
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