AUTHOR=Hobohm Lukas , Farmakis Ioannis T. , Münzel Thomas , Konstantinides Stavros , Keller Karsten TITLE=Pulmonary Embolism and Pregnancy—Challenges in Diagnostic and Therapeutic Decisions in High-Risk Patients JOURNAL=Frontiers in Cardiovascular Medicine VOLUME=9 YEAR=2022 URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.856594 DOI=10.3389/fcvm.2022.856594 ISSN=2297-055X ABSTRACT=

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.