Abstract
Pulmonary embolism (PE) complicates 5.4 per 10 000 pregnancies and remains a significant
cause of maternal mortality. Prompt diagnosis and treatment of PE are key to ensuring
optimal outcomes, but are not without risks associated with over-testing. Given the
paucity of evidence informing PE diagnosis in pregnancy, marked heterogeneity exists
among different societies in their recommendations.
Here we provide an overview of existing recommendations and novel evidence informing
the diagnosis of PE in pregnancy, including the use of d-dimers, the choice of diagnostic
imaging modality, and the potential for breast cancer risk among women exposed to
ionizing radiation from computed tomography pulmonary angiography (CTPA).
Résumé
L'embolie pulmonaire (EP) complique 5,4 par 10 000 grossesses et demeure une cause
importante de mortalité maternelle. Le diagnostic et le traitement rapides de l'EP
sont essentiels pour favoriser les issues optimales, mais pas sans le risque de procéder
à des analyses trop nombreuses en raison du manque d'algorithmes de prédiction du
risque normalisés dans le cadre obstétrical. Compte tenu de la rareté des données
probantes disponibles pour étayer le diagnostic d'EP pendant la grossesse, il existe
une hétérogénéité marquée entre les recommandations émises par les différentes sociétés.
Nous donnons ici un aperçu des recommandations actuelles et des nouvelles données
probantes sur le diagnostic de l'EP pendant la grossesse, notamment l'utilisation
des d-dimères, le choix de la modalité d'imagerie diagnostique et le risque potentiel
de cancer du sein chez les femmes exposées aux rayonnements ionisants de l'angiographie
pulmonaire par tomodensitométrie.
Keywords
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Article info
Publication history
Published online: April 28, 2020
Footnotes
Disclosures: The authors declare they have nothing to disclose.
All authors have indicated that they meet the journal's requirements for authorship.
Identification
Copyright
© 2020 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc.
