Non-Invasive Workup of Suspected PE in Pregnancy
Dec 04, 2024
This study looked at the safety and efficiency of non-invasive diagnostic approaches in pregnant patients suspected of having a pulmonary embolism(PE).
The Study
Milo A.M et al. Diagnostic work-up for suspected acute pulmonary embolism during pregnancy: a systematic review and meta-analysis of individual patient data. J Thromb Haemost. 2023;21:606–615
Bottom Line
This was a systematic review, which was limited by only 2 studies being included. They looked at Wells Score and YEARS criteria and D-Dimers. The 2 studies used different scoring systems ie., Wells vs Revised Geneva and so are limited in the conclusion we can draw. What I think was important is that they found that in pregnant patients with no leg pain, 127 compressive ultrsounds had to be performed to avoid one CTPA. This is in my view is clinically significant to my practice, given that ultrasound of the legs is sometimes recommended as the first diagnostic step. The yield, is very low if the patient is asymptomatic.
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