{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T15:40:02Z","timestamp":1745768402089,"version":"3.40.4"},"reference-count":14,"publisher":"BMJ","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ Case Reports"],"abstract":"<jats:p>Pulmonary thromboembolism (PTE) can result in significant adverse maternal and fetal outcomes. Monteplase\u2014a recombinant tissue plasminogen activator\u2014is considered effective for the treatment of PTE; however, only a few reports have described cases wherein surgical procedures were performed following treatment with monteplase. Here, we present a patient diagnosed with a massive PTE at 28\u2005weeks of gestation leading to maternal cardiac arrest and intrauterine fetal death. The patient was treated with percutaneous cardiopulmonary support and monteplase. Thrombolysis was achieved 30\u2005min after its administration. The patient went into spontaneous labour and delivered a stillborn vaginally. Using gauze tamponade and uterotonic agents, haemostasis was achieved after 4\u2005h, and bleeding completely ceased after 7\u2005h. Thus, we suggest that a thrombolytic agent can be administered in critical cases, even if delivery is expected shortly.<\/jats:p>","DOI":"10.1136\/bcr-2013-009431","type":"journal-article","created":{"date-parts":[[2013,5,24]],"date-time":"2013-05-24T05:54:51Z","timestamp":1369374891000},"page":"bcr2013009431","source":"Crossref","is-referenced-by-count":4,"title":["Recombinant tissue plasminogen activator for massive pulmonary thromboembolism"],"prefix":"10.1136","volume":"2013","author":[{"given":"Kouki","family":"Samejima","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasushi","family":"Takai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideyoshi","family":"Matsumura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroyuki","family":"Seki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2013,5,23]]},"reference":[{"key":"2025042708024788000_2013.may23_1.bcr2013009431.1","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1016\/S0140-6736(09)60996-X","article-title":"Pulmonary embolism in pregnancy","volume":"2013","author":"Bourjeily","year":"2010","journal-title":"Lancet"},{"key":"2025042708024788000_2013.may23_1.bcr2013009431.2","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1159\/000073590","article-title":"Thrombosis during pregnancy: risk factors, diagnosis and treatment","volume":"2013","author":"Pabinger","year":"2002","journal-title":"Pathophysiol Haemost Thromb"},{"key":"2025042708024788000_2013.may23_1.bcr2013009431.3","doi-asserted-by":"crossref","first-page":"401S","DOI":"10.1378\/chest.126.3_suppl.401S","article-title":"Antithrombotic therapy for venous thromboembolic disease: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy","volume":"2013","author":"Buller","year":"2004","journal-title":"Chest"},{"key":"2025042708024788000_2013.may23_1.bcr2013009431.4","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1016\/0140-6736(93)90274-K","article-title":"Alteplase versus heparin in acute pulmonary embolism: randomised trial assessing right-ventricular function and pulmonary perfusion","volume":"2013","author":"Goldhaber","year":"1993","journal-title":"Lancet"},{"key":"2025042708024788000_2013.may23_1.bcr2013009431.5","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1161\/01.CIR.0000137826.09715.9C","article-title":"Thrombolysis compared with heparin for the initial treatment of pulmonary embolism: a meta-analysis of the randomized controlled trials","volume":"2013","author":"Wan","year":"2004","journal-title":"Circulation"},{"key":"2025042708024788000_2013.may23_1.bcr2013009431.6","doi-asserted-by":"crossref","first-page":"1447","DOI":"10.1016\/S0735-1097(97)00074-0","article-title":"A prospective, randomized, double-blind multicenter trial of a single bolus injection of the novel modified t-PA E6010 in the treatment of acute myocardial infarction: comparison with native t-PA. E6010 Study Group","volume":"2013","author":"Kawai","year":"1997","journal-title":"J Am Coll Cardiol"},{"key":"2025042708024788000_2013.may23_1.bcr2013009431.7","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1097\/AOG.0b013e3182411907","article-title":"Preventing maternal death: 10 clinical diamonds","volume":"2013","author":"Clark","year":"2012","journal-title":"Obstet Gynecol"},{"key":"2025042708024788000_2013.may23_1.bcr2013009431.8","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1016\/S0002-9149(98)01000-5","article-title":"Recovery of regional right ventricular function after thrombolysis for pulmonary embolism","volume":"2013","author":"Nass","year":"1999","journal-title":"Am J Cardiol"},{"key":"2025042708024788000_2013.may23_1.bcr2013009431.9","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1136\/hrt.77.4.346","article-title":"Prognostic significance of right ventricular afterload stress detected by echocardiography in patients with clinically suspected pulmonary embolism","volume":"2013","author":"Kasper","year":"1997","journal-title":"Heart"},{"key":"2025042708024788000_2013.may23_1.bcr2013009431.10","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1016\/S0002-9343(98)00355-6","article-title":"Incidence and predictors of major hemorrhagic complications from thrombolytic therapy in patients with massive pulmonary embolism","volume":"2013","author":"Meyer","year":"1998","journal-title":"Am J Med"},{"key":"2025042708024788000_2013.may23_1.bcr2013009431.11","doi-asserted-by":"crossref","first-page":"1386","DOI":"10.1016\/S0140-6736(98)07534-5","article-title":"Acute pulmonary embolism: clinical outcomes in the International Cooperative Pulmonary Embolism Registry (ICOPER)","volume":"2013","author":"Goldhaber","year":"1999","journal-title":"Lancet"},{"key":"2025042708024788000_2013.may23_1.bcr2013009431.12","first-page":"941","article-title":"A pharmacokinetic and pharmacodynamic study (Phase IV) of Cleactor in patients with acute pulmonary thromboembolism (APTE)","volume":"2013","author":"Tanaka","year":"2009","journal-title":"Jpn Pharmacol Ther"},{"key":"2025042708024788000_2013.may23_1.bcr2013009431.13","first-page":"273","article-title":"Teratogenicity study in rats treated intravenously with E6010","volume":"2013","author":"Ogura","year":"1994","journal-title":"Jpn Pharmacol Ther"},{"key":"2025042708024788000_2013.may23_1.bcr2013009431.14","first-page":"291","article-title":"Teratogenicity study in rabbits treated intravenously with E6010","volume":"2013","author":"Niwa","year":"1994","journal-title":"Jpn Pharmacol Ther"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2013-009431","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T15:02:53Z","timestamp":1745766173000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2013-009431"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,5,23]]},"references-count":14,"alternative-id":["10.1136\/bcr-2013-009431"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2013-009431","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2013,5,23]]}}}