Pulmonary embolism in pregnancy: Difference between revisions

Revision as of 05:28, 15 May 2014

Also consider V/Q in young females in order to minimize radiation exposure to breast tissue
Also consider V/Q vs CTPA in pregnant females depending on multiple considerations including the above + radiation burden to fetus

Clinical features suggestive of PE
1. Bilateral LE Ultrasound
  1. Positive-->treat empirically for PE
  2. Negative-->CTA
    1. CT (with shield) vs. V/Q is roughly equilivalent radiation exposure

D-Dimer MAY BE used with following limits with very poor evidence^[1]^[2]
- 1st trimester: <750 ng/mL (+50% increase from normal lab threshold)
- 2nd trimester: <1000 ng/mL (+100% from normal)
- 3rd trimester: <1250 ng/mL (+150% from normal)

Admit

↑ Kovac M. The use of D-dimer with new cutoff can be useful in diagnosis of venous thromboembolism in pregnancy. Eur J Obstet Gynecol Reprod Biol. 2010 Jan;148(1):27-30
↑ http://blog.ercast.org/2013/04/pulmonary-embolism-in-pregnancy/

Authors:

@@ Line 16: / Line 16: @@
 ===D-Dimer===
 *D-Dimer MAY BE used with following limits with '''very poor evidence'''<ref>Kovac M. The use of D-dimer with new cutoff can be useful in diagnosis of venous thromboembolism in pregnancy. Eur J Obstet Gynecol Reprod Biol. 2010 Jan;148(1):27-30</ref><ref>http://blog.ercast.org/2013/04/pulmonary-embolism-in-pregnancy/</ref>
-**1st trimester: <750 (+50% increase from normal lab threshold)
+**1st trimester: <750 ng/mL (+50% increase from normal lab threshold)
-**2nd trimester: <1000 (+100% from normal)
+**2nd trimester: <1000 ng/mL (+100% from normal)
-**3rd trimester: <1250 (+150% from normal)
+**3rd trimester: <1250 ng/mL (+150% from normal)
 ==Management==