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[7] [8] Diagnostic algorithms for pulmonary embolism in pregnancy vary; however, a common compromise is to perform ultrasound testing for deep vein thrombosis of the legs, and if this is positive, make the diagnosis of pulmonary embolism on the basis of symptoms and presence of the DVT. CTPA would then only be performed if exhaustive non ...
A V/Q scan confers a higher radiation dose to the fetus, while a CTPA confers a much higher radiation dose to the mother's breasts. A review from the United Kingdom in 2005 considered CTPA to be generally preferable in suspected pulmonary embolism in pregnancy because of higher sensitivity and specificity as well as a relatively modest cost. [7]
Pre-eclampsia is a multi-system disorder specific to pregnancy, characterized by the new onset of high blood pressure and often a significant amount of protein in the urine or by the new onset of high blood pressure along with significant end-organ damage, with or without the proteinuria.
Pulmonary embolism (PE) is a blockage of an artery in the lungs by a substance that has moved from elsewhere in the body through the bloodstream . [6] Symptoms of a PE may include shortness of breath , chest pain particularly upon breathing in, and coughing up blood . [ 1 ]
The Geneva score is a clinical prediction rule used in determining the pre-test probability of pulmonary embolism (PE) based on a patient's risk factors and clinical findings. [1] It has been shown to be as accurate as the Wells Score , and is less reliant on the experience of the doctor applying the rule. [ 2 ]
A pregnant woman will also become hypercoagulable, leading to increased risk for developing blood clots and embolisms, such as deep vein thrombosis and pulmonary embolism. Women are 4-5 times more likely to develop a clot during pregnancy and in the postpartum period than when they are not pregnant. [25]
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Wells score for PE [3] Variable Points Clinical signs and symptoms of DVT 3 An alternate diagnosis is less likely than PE 3 Heart rate >100 1.5 Immobilization or surgery in the previous 4 weeks 1.5 Previous DVT / PE 1.5 Hemoptysis 1 Malignancy (treatment currently, in the previous 6 months, or palliative) 1