Acute iliac vein thrombosis in pregnancy treated successfully by streptokinase lysis: a case report

Background: Postthrombotic syndrome is an important late complication after deep vein thrombosis in pregnancy. Thrombolytic agents are more efficient in preventing this condition but are rarely used in pregnant women. Case: A 22-year-old woman at 29 weeks of gestation presented with acute iliac vein thrombosis. After application of a heparin bolus, systemic streptokinase lysis was performed. Low-dose heparin therapy was continued for the remainder of the, otherwise unremarkable, pregnancy. Spontaneous delivery of a healthy girl was without complications and thromboprophylaxis with low-molecular heparin was continued. Conclusion: Thrombolysis in pregnancy is possible and may help to prevent severe long-term sequelae of thrombosis in young women. Bleeding is a major risk, which must be considered and therapy should only be administered under close observation.